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http://dx.doi.org/10.7314/APJCP.2014.15.21.9085

Phytoestrogen Intake and Risk of Ovarian Cancer: a Meta-Analysis of 10 Observational Studies  

Qu, Xin-Lan (The Reproductive Medicine Center, Zhongnan Hospital of Wuhan University)
Fang, Yuan (Department of Oncology, Zhongnan Hospital of Wuhan University)
Zhang, Ming (The Reproductive Medicine Center, Zhongnan Hospital of Wuhan University)
Zhang, Yuan-Zhen (The Reproductive Medicine Center, Zhongnan Hospital of Wuhan University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.21, 2014 , pp. 9085-9091 More about this Journal
Abstract
Background: Epidemiology studies have shown an inconclusive relationship between phytoestrogen intake and ovarian cancer risk and there have been no relevant meta-analyses directly regarding this topic. The purpose of the present meta-analysis was therefore to investigate any association between phytoestrogen intake and ovarian cancer in detail. Materials and Methods: We conducted a search of PubMed, EMBASE, EBSCO, the Cochrane Library, CNKI and Chinese Biomedical Database (up to April 2014) using common keywords for studies that focused on phytoestrogen and ovarian cancer risk. Study-specific risk estimates (RRs) were pooled using fixed effect or random-effect models. Results: Ten epidemiologic studies were finally included in the meta-analysis. The total results indicated higher phytoestrogen intake was associated with a reduced ovarian cancer risk (RR, 0.70; 95%CI: 0.56-0.87). The association was similar in sensitivity analysis. Meta regression analysis demonstrated sources and possibly types and regions as heterogeneous factors. Subgroup analysis of types, sources and regions showed that isoflavones (RR: 0.63; 95%CI: 0.46, 0.86), soy foods (RR: 0.51; 95%CI: 0.39, 0.68) and an Asian diet (RR: 0.48; 95%CI: 0.37, 0.63) intake could reduce the incidence of ovarian cancer. Conclusions: Our findings show possible protection by phytoestrogens against ovarian cancer. We emphasize specific phytoestrogens from soy foods, but not all could reduce the risk. The habit of plentiful phytoestrogen intake by Asians is worthy to recommendation. However, we still need additional larger well designed observational studies to fully characterize underlying associations.
Keywords
Phytoestrogen; ovarian cancer; meta-analysis; isoflavones; soy food;
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1 Allred CD, Allred KF, Ju YH, Virant SM, Helferich WG (2001). Soy diets containing varying amounts of genistein stimulate growth of estrogen-dependent (MCF-7) tumors in a dosedependent manner. Cancer Res, 61, 5045-50.
2 Andres S, Appel KAK (2011). Risks and benefits of dietary isoflavones for cancer. Crit Rev Toxicol, 41, 463-506.   DOI   ScienceOn
3 Bandera EV, King M, Chandran U, et al (2011). Phytoestrogen consumption from foods and supplements and epithelial ovarian cancer risk: a population-based case control study. BMC Womens Health, 11, 40.   DOI
4 Banerjee S, Li Y, Wang Z, Sarkar FH (2008). Multi-targeted therapy of cancer by genistein. Cancer Lett, 269, 226-42.   DOI   ScienceOn
5 Begg CB, Mazumdar M (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50, 1088-101.   DOI   ScienceOn
6 Chang ET, Lee VS, Canchola AJ, et al (2007). Diet and risk of ovarian cancer in the California Teachers Study cohort. Am J Epidemiol, 165, 802-13.   DOI
7 Chen X, Anderson JJ (2001). Isoflavones inhibit proliferation of ovarian cancer cells in vitro via an estrogen receptor-dependent pathway. Nutr Cancer, 41, 165-71.   DOI
8 Choi EJ, Kim T, Lee MS (2007). Pro-apoptotic effect and cytotoxicity of genistein and genistin in human ovarian cancer SK-OV-3 cells. Life Sci, 80, 1403-8.   DOI
9 DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7, 177-88.   DOI   ScienceOn
10 Dong JY, Zhang YH, Qin LQ (2011). Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol, 58, 1378-85.   DOI   ScienceOn
11 Dorward AM, Shultz KL, Beamer WG (2007). LH analog and dietary isoflavones support ovarian granulosa cell tumor development in a spontaneous mouse model. Endocr Relat Cancer, 14, 369-79.   DOI
12 Egger M, Davey SG, Schneider M, Minder C (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315, 629-34.   DOI   ScienceOn
13 Gates MA, Tworoger SS, Hecht JL, et al (2007). A prospective study of dietary flavonoid intake and incidence of epithelial ovarian cancer. Int J Cancer, 121, 2225-32.   DOI   ScienceOn
14 Gates MA, Vitonis AF, Tworoger SS, et al (2009). Flavonoid intake and ovarian cancer risk in a population-based casecontrol study. Int J Cancer, 124, 1918-25.   DOI   ScienceOn
15 Gercel-Taylor C, Feitelson AK, Taylor DD (2004). Inhibitory effect of genistein and daidzein on ovarian cancer cell growth. Anticancer Res, 24, 795-800.
16 Gossner G, Choi M, Tan L, et al (2007). Genistein-induced apoptosis and autophagocytosis in ovarian cancer cells. Gynecol Oncol, 105, 23-30.   DOI
17 Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557-60.   DOI   ScienceOn
18 Green JM, Alvero AB, Kohen F, Mor G (2009). 7-(O)-Carboxymethyl daidzein conjugated to N-t-Boc-hexylenediamine: a novel compound capable of inducing cell death in epithelial ovarian cancer stem cells. Cancer Biol Ther, 8, 1747-53.   DOI
19 Hall JM, Couse JF, Korach KS (2001). The multifaceted mechanisms of estradiol and estrogen receptor signaling. J Biol Chem, 276, 36869-72.   DOI   ScienceOn
20 Hedelin M, Lof M, Andersson TM, Adlercreutz H, Weiderpass E (2011). Dietary phytoestrogens and the risk of ovarian cancer in the women's lifestyle and health cohort study. Cancer Epidemiol Biomarkers Prev, 20, 308-17.   DOI
21 Jefferson WN, Couse JF, Padilla-Banks E, Korach KS, Newbold RR (2002). Neonatal exposure to genistein induces estrogen receptor (ER)alpha expression and multioocyte follicles in the maturing mouse ovary: evidence for ERbeta-mediated and nonestrogenic actions. Biol Reprod, 67, 1285-96.   DOI   ScienceOn
22 Jefferson WN, Patisaul HB, Williams CJ (2012). Reproductive consequences of developmental phytoestrogen exposure. Reproduction, 143, 247-60.   DOI
23 Kang HB, Zhang YF, Yang JD, Lu KL (2012). Study on soy isoflavone consumption and risk of breast cancer and survival. Asian Pac J Cancer Prev, 13, 995-8.   과학기술학회마을   DOI   ScienceOn
24 Kim SH, Park MJ (2012). Effects of phytoestrogen on sexual development. Korean J Pediatr, 55, 265-71.   과학기술학회마을   DOI
25 Manzoli L, Villari P, M PG, Boccia A (2007). Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med, 64, 77-94.   DOI   ScienceOn
26 Lee AH, Su D, Pasalich M, Tang L, Binns CW, Qiu L (2014). Soy and isoflavone intake associated with reduced risk of ovarian cancer in southern Chinese women. Nutr Res, 34, 302-7.   DOI
27 Leung PC, Choi JH (2007). Endocrine signaling in ovarian surface epithelium and cancer. Hum Reprod Update, 13, 143-62.
28 Luo H, Jiang BH, King SM, Chen YC (2008). Inhibition of cell growth and VEGF expression in ovarian cancer cells by flavonoids. Nutr Cancer, 60, 800-9.   DOI   ScienceOn
29 McCann SE, Freudenheim JL, Marshall JR, Graham S (2003). Risk of human ovarian cancer is related to dietary intake of selected nutrients, phytochemicals and food groups. J Nutr, 133, 1937-42.
30 Ning Y, Li Q, Xiang H, Liu F, Cao J (2012). Apoptosis induced by 7-difluoromethoxyl-5,4'-di-n-octyl genistein via the inactivation of FoxM1 in ovarian cancer cells. Oncol Rep, 27, 1857-64.
31 Ososki AL, Kennelly EJ (2003). Phytoestrogens: a review of the present state of research. Phytother Res, 17, 845-69.   DOI   ScienceOn
32 Rossi M, Bosetti C, Negri E, Lagiou P, La Vecchia C (2010). Flavonoids, proanthocyanidins, and cancer risk: a network of case-control studies from Italy. Nutr Cancer, 62, 871-7.   DOI
33 Rossi M, Negri E, Lagiou P, et al (2008). Flavonoids and ovarian cancer risk: A case-control study in Italy. Int J Cancer, 123, 895-8.   DOI
34 Srisuttayasathien M, Khemapech N (2013). Quality of life in ovarian cancer patients choosing to receive salvage chemotherapy or palliative treatment. Asian Pac J Cancer Prev, 14, 7669-74.   과학기술학회마을   DOI   ScienceOn
35 Rucinska A, Kirko S, Gabryelak T (2007). Effect of the phytoestrogen, genistein-8-C-glucoside, on Chinese hamster ovary cells in vitro. Cell Biol Int, 31, 1371-8.   DOI
36 Sakauchi F, Khan MM, Mori M, et al (2007). Dietary habits and risk of ovarian cancer death in a large-scale cohort study (JACC study) in Japan. Nutr Cancer, 57, 138-45.   DOI
37 Solomon LA, Ali S, Banerjee S (2008). Sensitization of ovarian cancer cells to cisplatin by genistein: the role of NF-kappaB. J Ovarian Res, 1, 9.   DOI
38 Sugiyama Y, Masumori N, Fukuta F, et al (2013). Influence of isoflavone intake and equol-producing intestinal flora on prostate cancer risk. Asian Pac J Cancer Prev, 14, 1-4.   과학기술학회마을   DOI   ScienceOn
39 Tamaya T (2005). Phytoestrogens and reproductive biology. Reprod Med Biol, 4, 225-9.   DOI
40 Tanaka T, Kohno H, Tanino M, Yanaida Y (2002). Inhibitory effects of estrogenic compounds, 4-nonylphenol and genistein, on 7,12-dimethylbenz[a]anthracene-induced ovarian carcinogenesis in rats. Ecotoxicol Environ Saf, 52, 38-45.   DOI
41 Thasni KA, Rojini G, Rakesh SN, et al (2008). Genistein induces apoptosis in ovarian cancer cells via different molecular pathways depending on breast cancer susceptibility gene-1 (BRCA1) status. Eur J Pharmacol, 588, 158-64.   DOI
42 WOOLF B (1955). On estimating the relation between blood group and disease. Ann Hum Genet, 19, 251-3.   DOI   ScienceOn
43 Wang L, Lee IM, Zhang SM, (2009). Dietary intake of selected flavonols, flavones, and flavonoid-rich foods and risk of cancer in middle-aged and older women. Am J Clin Nutr, 89, 905-12.   DOI
44 Wells G, Shea B, O Connell D, Peterson J, Welch V, Losos M, et al. The newcastle - scale(NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (cited 19 March 2011).
45 Woclawek-Potocka I, Mannelli C, Boruszewska D, Kowalczyk-Zieba I, Wasniewski T, Skarzynski DJ (2013). Diverse effects of phytoestrogens on the reproductive performance: cow as a model. Int J Endocrinol, 2013, 650984.
46 Yang WS, Va P, Wong MY, Zhang HL, Xiang YB (2011). Soy intake is associated with lower lung cancer risk: results from a meta-analysis of epidemiologic studies. Am J Clin Nutr, 94, 1575-83.   DOI
47 Zhang M, Xie X, Lee AH, Binns CW (2004). Soy and isoflavone intake are associated with reduced risk of ovarian cancer in southeast china. Nutr Cancer, 49, 125-30.   DOI
48 Zhang YF, Kang HB, Li BL, Zhang RM (2012). Positive effects of soy isoflavone food on survival of breast cancer patients in China. Asian Pac J Cancer Prev, 13, 479-82.   과학기술학회마을   DOI   ScienceOn
49 Zhao E, Mu Q (2011). Phytoestrogen biological actions on mammalian reproductive system and cancer growth. Sci Pharm, 79, 1-20.   DOI   ScienceOn