Phyto-oestrogen Intake and Breast Cancer Risk in South Asian Women in England: Findings from a Population-based Case-Control Study
Objective: This study investigates whether intake of phyto-oestrogens is associated with breast cancer risk in South Asian women from the Indian subcontinent, whose diet is rich in pulses and vegetables but poor in soyfoods.
Methods: A total of 240 South Asian breast cancer cases living in England and 477 age-matched population-based controls were recruited into the study. Dietary intake was measured using a validated food frequency questionnaire. Conditional logistic regression models were used to estimate the effect of phyto-oestrogen intake on breast cancer risk.
Results: After adjustment for known breast cancer risk factors and total energy intake, there was moderate evidence of a dose-effect response in the odds of breast cancer with isoflavone intake (p-value for trend 0.08), with women in the top quartile having approximately half the odds of breast cancer of those in the bottom one (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.33, 1.00) but with no reductions in the odds for women in the second and third quartiles. The ORs for second, third and highest quartiles of total lignan intake compared to the lowest were 0.78 (95% CI 0.48, 1.26), 0.74 (0.46, 1.19) and 0.66 (0.41, 1.07), respectively, again with moderate evidence of a linear dose-effect response (p-value for trend 0.09). Further adjustment for non-startch polysaccharides (NSP) intake slightly weakened the phyto-oestrogens-breast cancer associations.
Conclusions: These findings are consistent with the possibility that high phyto-oestrogen intake may protect against breast cancer, but further research is required to confirm this hypothesis.
Unable to display preview. Download preview PDF.
- 1.Endogenous Hormones and Breast Cancer Collaborative Group (2002)Endogenous sex hormones and breast cancer risk in postmenopausal women:re-analysis of nine prospective studies. J Natl Cancer Inst 94:606-616.Google Scholar
- 2.Collaborative Group on Hormonal Factors in Breast Cancer (1997)Breast cancer and hormone replacement therapy.Combined reanalysis of data from 51 epidemiological studies involving 52,705 women with breast cancer.Lancet 350:1047-1059.Google Scholar
- 4.Barnes S (1998).Phytoestrogens and breast cancer.In:Adlercruetz H,ed.Phytoestrogens.Baillie`re's Clinical Endocrinology and Metabolism,Vol.12.London: Baillie`re Tindall,559-579.Google Scholar
- 5.Mazur W (1998)Phytoestrogen content in foods.In:Adlercruetz H,ed.Phytoestrogens.Baillie`re's Clinical Endocrinology and Metabolism,Vol.12.London: Baillie`re Tindall,729-742.Google Scholar
- 7.Horn-Ross PL, John EM, Lee M,et al.(2001)Phytoestrogen comsumption and breast cancer risk in a multiethnic population.The Bay Area Breast Cancer Study.Am J Epidemiol 154:434-441.Google Scholar
- 9.Ackroyd WR, Doughty J, Walker A (1982)Legumes in Human Nutrition.Rome:Food and Agriculture Organisation of the United Nations.Google Scholar
- 13.Sevak L, Mangtani P, McCormack V, Bhakta D, Kassam-Khamis T, dos Santos Silva I (in press)Validation of a food frequency questionnaire to assess macro-and micro-nutrient intake among South Asians in the United Kingdom.Eur J Nutr.Google Scholar
- 16.Bhakta D (2003)Comparison of dietary patterns of South Asian migrants and native British women,with a particular focus on the intake and biological levels of phyto-oestrogens.PhD thesis. London: University of London.Google Scholar
- 19.COMP-EAT 5 (1998)COMP-EAT versions 5.London: Nutrition Systems.Google Scholar
- 20.Breslow NE,Day NE (1980)Statistical Methods in Cancer Research.Vol.1.The Analysis of Case-Control Studies.Lyon: International Agency for Research on Cancer.Google Scholar
- 21.Willett W,ed.(1998)Nutritional Epidemiology Monographs in Epidemiology and Biostatistics Vol.30 2nd ednOxford: Oxford University Press.Google Scholar
- 23.Bingham SA, Liggins J, Bluck L, Coward L (1998)Iso avone Concentrations in Foods:The Biological Effects of Phyto-oestrogens.London: Ministry of Agriculture,Fisheries and Foods.Google Scholar
- 24.Mazur W, Duke J, Wahala K, Rasku S, Adlercreutz H (1998) Iso.avonoids and lignans in legumes:nutritional and health aspects in humans.Nutr Biochem 9:1-8.Google Scholar
- 28.Strom SS, Yamamura Y, Duphorne CM,et al.(1999)Phytoes-trogens intake and prostate cancer:a case-control study using a new database.Nutr Cancer31:20-25.Google Scholar
- 33.Jakes RW, Duffy SW, Ng FC,et al.(2002)Mammographic parenchymal patterns and self-reported soy intake in Singapore Chinese women.Cancer Epidemiol.Biomark Prev 11:608-613.Google Scholar
- 34.Hirayama T (1990)Life-style and mortality:a large-scale census-based cohort study in Japan.In:Wahrendorf J,ed.Contributions to Epidemiology and Biostatistics Vol.6.Karger: Basil.Google Scholar
- 35.Greenstein J, Kushi L, Zheng W,et al.(1996).Risk of breast cancer associated with intake of specific foods and food groups. Am J Epidemiol 143:S36 (141).Google Scholar
- 43.Wu AH, Ziegler RG, Horn-Ross PL,et al.(1996)Tofu and risk of breast cancer in Asian-American.Cancer Epidemiol Biomark Prev 5:901-906.Google Scholar
- 45.Shu X-O, Jin F, Dai Q,et al.(2001)Soyfood intake during adolescence and subsequent risk of breast cancer among Chinese women.Cancer Epidemiol Biomark Prev 10:483-488.Google Scholar
- 48.den Tonkelaar I, Keinan-Boker L, Van't Veer P,et al.(2001) Urinary phytoestrogens and postmenopausal breast cancer risk. Cancer Epidemiol Biomark Prev 10:223-228.Google Scholar
- 51.Zheng W, Dai Q, Custer LJ,et al (1999)Urinary excretion of iso avonoids and the risk of breast cancer.Cancer Epidemiol Biomark Prev8:35-40.Google Scholar
- 53.Pietinen P, Stumpf K, Männistö S, Kataja V, Uusitupa M, Adlercreutz H (2001)Serum enterolactone and risk of breast cancer:a case-control study in Eastern Finland.Cancer Epidemiol Biomark Prev 10:339-344.Google Scholar
- 54.Dai Q, Frankle AA, Jin F,et al.(2002)Urinary excretion of phytoestrogen and risk of breast cancer among Chinese women in Shangai.Cancer Epidemiol Biomark Prev 11:815-821.Google Scholar