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Meta-Analysis
. 2022 May 11;21(1):27.
doi: 10.1186/s12937-022-00778-w.

Consumption of flavonoids and risk of hormone-related cancers: a systematic review and meta-analysis of observational studies

Fubin Liu  1   2   3 , Yu Peng  1   2   3 , Yating Qiao  1   2   3 , Yubei Huang  1   2   3 , Fengju Song  1   2   3 , Ming Zhang  4 , Fangfang Song  5   6   7
Affiliations
Meta-Analysis

Consumption of flavonoids and risk of hormone-related cancers: a systematic review and meta-analysis of observational studies

Fubin Liu et al. Nutr J. .

Abstract

Background: Flavonoids seem to have hormone-like and anti-hormone properties so that the consumption of flavonoids may have potential effects on hormone-related cancers (HRCs), but the findings have been inconsistent so far. This meta-analysis was aimed to explore the association between flavonoids intake and HRCs risk among observational studies.

Methods: Qualified articles, published on PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) from January 1999 to March 2022 and focused on relationships between flavonoids (total, subclass of and individual flavonoids) and HRCs (breast, ovarian, endometrial, thyroid, prostate and testicular cancer), were retrieved for pooled analysis. Random effects models were performed to calculate the pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Funnel plots and Begg's/Egger's test were used to evaluate the publication bias. Subgroup analyses and sensitivity analyses were conducted to explore the origins of heterogeneity.

Results: All included studies were rated as medium or high quality. Higher consumption of flavonols (OR = 0.85, 95% CI: 0.76-0.94), flavones (OR = 0.85, 95% CI: 0.77-0.95) and isoflavones (OR = 0.87, 95% CI: 0.82-0.92) was associated with a decreased risk of women-specific cancers (breast, ovarian and endometrial cancer), while the higher intake of total flavonoids was linked to a significantly elevated risk of prostate cancer (OR = 1.11, 95% CI: 1.02-1.21). A little evidence implied that thyroid cancer risk was augmented with the higher intake of flavones (OR = 1.24, 95% CI: 1.03-1.50) and flavanones (OR = 1.31, 95% CI: 1.09-1.57).

Conclusions: The present study suggests evidence that intake of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols and isoflavones would be associated with a lower or higher risk of HRCs, which perhaps provides guidance for diet guidelines to a certain extent.

Trial registration: This protocol has been registered on PROSPERO with registration number CRD42020200720 .

Keywords: Flavonoid subclasses; Flavonoids; Hormone-related cancers; Meta-analysis; Observational studies.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for retrieving articles and selecting eligible studies. *CNKI, China National Knowledge Infrastructure; CI, confidence interval
Fig. 2
Fig. 2
Forest plots for the association between total/subclass of flavonoids consumption and hormone-related cancer risk. A breast cancer; B ovarian cancer; C endometrial cancer; D thyroid cancer; E prostate cancer. Use (1) and (2) to distinguish two different studies by the same author in the same year; two datasets of the same study were represented by (a) and (b). *ES, effect size; CI, confidence interval
Fig. 3
Fig. 3
Forest plots for the association between individual flavonoid compounds consumption and hormone-related cancer risk. A breast cancer; B ovarian cancer. *ES, effect size; CI, confidence interval
Fig. 4
Fig. 4
Funnel plots for the association between flavonoid consumption and hormone-related cancer risk. A breast cancer; B ovarian cancer; C endometrial cancer; D prostate cancer
Fig. 5
Fig. 5
Plots of sensitivity analyses by sequential removal of each study. A breast cancer; B ovarian cancer; C women-specific cancers; D prostate cancer; E men-specific cancers. *BC, breast cancer; EC, endometrial cancer; OC, ovarian cancer; PC, prostate cancer; TC, testicular cancer
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