Intake of total, classes, and subclasses of (poly)phenols and risk of lymphoid neoplasms: a prospective analysis in the EPIC cohort

Enrique Almanza-Aguilera^#¹, David Guananga-Álvarez^#^{2

3}, Yolanda Benavente^{2

4}, Alexandra Nieters⁵, Caroline Besson^{6

7

8}, Fatemeh Saberi Hosnijeh⁹, Cecilie Kyrø¹⁰, Nicola P Bondonno^{10

11}, Christina C Dahm¹², Elisabete Weiderpass¹³, Therese Truong¹⁴, Mariem Louati-Hajji¹⁴, Xuan Ren¹⁴, Verena Katzke¹⁵, Matthias B Schulze^{16

17}, Fabrizio Pasanisi¹⁸, Claudia Vener¹⁹, Giovanna Masala²⁰, Maria Teresa Giraudo²¹, Rosario Tumino²², Amaia Aizpurua²³, Maria-Jose Sánchez^{4

24

25}, José María Huerta^{4

26}, Marcela Guevara^{4

27

28}, Cristina Lasheras²⁹, Paolo Vineis³⁰, Roel Vermeulen⁹, Raul Zamora-Ros¹, Delphine Casabonne^{31

32}

Affiliations

¹ Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain, Barcelona, Spain.
² Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
³ Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
⁴ Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
⁵ Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ Department of Hematology and Oncology, Hospital of Versailles, Le Chesnay, France.
⁷ CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
⁸ Gustave Roussy, Villejuif, France.
⁹ Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
¹⁰ The Danish Cancer Institute, Copenhagen, Denmark.
¹¹ Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
¹² Department of Public Health, Aarhus University, Aarhus, Denmark.
¹³ International Agency for Research on Cancer (IARC/WHO), Lyon, France.
¹⁴ Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Team "Exposome, Heredity, Cancer and Health", CESP, Villejuif, France.
¹⁵ Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
¹⁶ Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
¹⁷ Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
¹⁸ Internal Medicine and Clinical Nutrition, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
¹⁹ Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
²⁰ Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
²¹ Centre for Biostatistics, Epidemiology and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.
²² Hyblean Association for Epidemiological Research, AIRE-ONLUS Ragusa, Ragusa, Italy.
²³ BioGipuzkoa (BioDonostia) Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain.
²⁴ Escuela Andaluza de Salud Pública (EASP), Granada, Spain.
²⁵ Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
²⁶ Department of Epidemiology, Murcia Regional Health Council-IMIB, Murcia, Spain.
²⁷ Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
²⁸ Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
²⁹ Functional Biology Department, University of Oviedo, Oviedo, Spain.
³⁰ MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
³¹ Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain. dcasabonne_ext@iconcologia.net.
³² Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. dcasabonne_ext@iconcologia.net.

^# Contributed equally.

PMID: 41044175
PMCID: PMC12689600 (available on 2026-10-04)
DOI: 10.1038/s41416-025-03228-6

Intake of total, classes, and subclasses of (poly)phenols and risk of lymphoid neoplasms: a prospective analysis in the EPIC cohort

Enrique Almanza-Aguilera et al. Br J Cancer. 2025 Dec.

. 2025 Dec;133(12):1864-1871.

doi: 10.1038/s41416-025-03228-6. Epub 2025 Oct 4.

Authors

Affiliations

¹ Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain, Barcelona, Spain.
² Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
³ Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
⁴ Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
⁵ Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ Department of Hematology and Oncology, Hospital of Versailles, Le Chesnay, France.
⁷ CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
⁸ Gustave Roussy, Villejuif, France.
⁹ Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
¹⁰ The Danish Cancer Institute, Copenhagen, Denmark.
¹¹ Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
¹² Department of Public Health, Aarhus University, Aarhus, Denmark.
¹³ International Agency for Research on Cancer (IARC/WHO), Lyon, France.
¹⁴ Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Team "Exposome, Heredity, Cancer and Health", CESP, Villejuif, France.
¹⁵ Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
¹⁶ Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
¹⁷ Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
¹⁸ Internal Medicine and Clinical Nutrition, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
¹⁹ Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
²⁰ Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
²¹ Centre for Biostatistics, Epidemiology and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.
²² Hyblean Association for Epidemiological Research, AIRE-ONLUS Ragusa, Ragusa, Italy.
²³ BioGipuzkoa (BioDonostia) Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain.
²⁴ Escuela Andaluza de Salud Pública (EASP), Granada, Spain.
²⁵ Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
²⁶ Department of Epidemiology, Murcia Regional Health Council-IMIB, Murcia, Spain.
²⁷ Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
²⁸ Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
²⁹ Functional Biology Department, University of Oviedo, Oviedo, Spain.
³⁰ MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
³¹ Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain. dcasabonne_ext@iconcologia.net.
³² Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. dcasabonne_ext@iconcologia.net.

^# Contributed equally.

PMID: 41044175
PMCID: PMC12689600 (available on 2026-10-04)
DOI: 10.1038/s41416-025-03228-6

Abstract

Background: Existing epidemiological evidence regarding the potential role of (poly)phenol intake in lymphoma development is limited.

Methods: We investigated the associations between the intake of total and individual classes and subclasses of (poly)phenols and the risk of lymphoma, including main frequent subtypes in the EPIC cohort using multivariable-adjusted Cox proportional hazards models.

Results: During a mean 14-year follow-up (time frame: from 1990-1994 to 2008-2013), 2394 incident lymphoma cases were diagnosed from a total of 367,463 individuals. No significant associations were observed between total intakes of (poly)phenols, flavonoids, and phenolic acids and overall lymphoma risk. Total (poly)phenols, phenolic acid and hydroxycinnamic acid intakes were positively associated with Hodgkin lymphoma (HL) risk [HR_log2 = 2.56 (95% confidence interval: 1.27-5.16); 1.81 (1.14-2.87); and 1.48 (1.03-2.12), respectively]. Conversely, isoflavone intakes was inversely associated with risk of overall lymphoma [HR_log2 = 0.96 (0.93-0.99)], and non-Hodgkin lymphoma [HR_log2 = 0.95 (0.92-0.99)] and mature B-cell lymphoma [HR_log2 = 0.96 (0.92-0.99)], and flavone intakes with risk of multiple myeloma/plasma cell neoplasm [HR_log2 = 0.75 (0.60-0.95)].

Conclusions: Our findings suggest that isoflavone intakes may reduce the risk of overall lymphoma and specific lymphoma subtypes, while phenolic acids, particularly hydroxycinnamic acids might increase the risk of HL.

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Conflict of interest statement

Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the International Agency for Research on Cancer (IARC) and local ethical committees pertaining to EPIC Centers (PR194/18). All participants gave written informed consent. Competing interests: The authors declare no competing interests.

References

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Intake of total, classes, and subclasses of (poly)phenols and risk of lymphoid neoplasms: a prospective analysis in the EPIC cohort

Affiliations

Intake of total, classes, and subclasses of (poly)phenols and risk of lymphoid neoplasms: a prospective analysis in the EPIC cohort

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical