Circulating isoflavone and lignan concentrations and prostate cancer risk: a meta-analysis of individual participant data from seven prospective studies including 2,828 cases and 5,593 controls
Journal article, 2018

Phytoestrogens may influence prostate cancer development. This study aimed to examine the association between prediagnostic circulating concentrations of isoflavones (genistein, daidzein, equol) and lignans (enterolactone and enterodiol) and the risk of prostate cancer. Individual participant data were available from seven prospective studies (two studies from Japan with 241 cases and 503 controls and five studies from Europe with 2,828 cases and 5,593 controls). Because of the large difference in circulating isoflavone concentrations between Japan and Europe, analyses of the associations of isoflavone concentrations and prostate cancer risk were evaluated separately. Prostate cancer risk by study-specific fourths of circulating concentrations of each phytoestrogen was estimated using multivariable-adjusted conditional logistic regression. In men from Japan, those with high compared to low circulating equol concentrations had a lower risk of prostate cancer (multivariable-adjusted OR for upper quartile [Q4] vs. Q1 = 0.61, 95% confidence interval [CI] = 0.39–0.97), although there was no significant trend (OR per 75 percentile increase = 0.69, 95 CI = 0.46–1.05, ptrend = 0.085); Genistein and daidzein concentrations were not significantly associated with risk (ORs for Q4 vs. Q1 = 0.70, 0.45–1.10 and 0.71, 0.45–1.12, respectively). In men from Europe, circulating concentrations of genistein, daidzein and equol were not associated with risk. Circulating lignan concentrations were not associated with the risk of prostate cancer, overall or by disease aggressiveness or time to diagnosis. There was no strong evidence that prediagnostic circulating concentrations of isoflavones or lignans are associated with prostate cancer risk, although further research is warranted in populations where isoflavone intakes are high.


pooled analysis

prostate cancer risk




Aurora Perez-Cornago

University of Oxford

Paul N. Appleby

University of Oxford

Heiner Boeing

German Institute of Human Nutrition

Leire Gil

Public Health Division of Gipuzkoa-BIODONOSTIA

CIBER in Epidemiology and Public Health (CIBERESP)

C. Kyro

Danish Cancer Research Society Center

Fulvio Ricceri

Regional Health Service ASL TO3

University of Turin

Neil Murphy

International Agency for Research on Cancer (IARC)

Antonia Trichopoulou

Hellenic Health Foundation, Athens

Konstantinos K. Tsilidis

University of Ioannina

Imperial College London

Kay Tee Khaw

University of Cambridge

Robert N. Luben

University of Cambridge

Randi E. Gislefoss

Cancer Registry of Norway Institute of Population-Based Cancer Research

Hilde Langseth

Cancer Registry of Norway Institute of Population-Based Cancer Research

Isabel Drake

Lund University

Emily Sonestedt

Lund University

Peter Wallström

Skåne University Hospital

Lund University

Pär Stattin

Uppsala University

A. Johansson

Umeå University

Rikard Landberg

Umeå University

Chalmers, Biology and Biological Engineering, Food and Nutrition Science

Lena Nilsson

Umeå University

Kotaro Ozasa

Radiation Effects Research Foundation Hiroshima

Akiko Tamakoshi

Hokkaido University

Kazuya Mikami

Kyoto Prefectural University of Medicine

Tatsuhiko Kubo

University of Occupational and Environmental Health

Norie Sawada

National Cancer Center Tokyo

Shoichiro Tsugane

National Cancer Center Tokyo

Timothy J. Key

University of Oxford

Naomi E. Allen

University of Oxford

Ruth C. Travis

University of Oxford

International Journal of Cancer

0020-7136 (ISSN) 1097-0215 (eISSN)

Vol. 143 11 2677-2686

Subject Categories

Urology and Nephrology

Cancer and Oncology





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