Isoflavones from Phytoestrogens and Gastric Cancer Risk: A Nested Case-Control Study within the Korean Multicenter Cancer Cohort

Background: The role of soybean products in gastric cancer risk is not clear in epidemiologic studies due to measurement error from dietary intake questionnaires and due to different degrees of bias according to study design. To examine the association between soybean products and gastric cancer risk, we measured phytoestrogen biological markers in a nested case-control study. Methods: The study population was composed of 131 cases and 393 matched controls within the Korean Multicenter Cancer Cohort. The concentrations of the four biomarkers in the plasma samples were measured using time-resolved fluoroimmunoassay. Conditional and unconditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence intervals (CI). Results: Median plasma concentrations of genistein (229 nmol/L for controls, 181.8 nmol/L for cases; P = 0.07) and daidzein (131.2 nmol/L for controls, 80.5 nmol/L for cases; P = 0.04) in cases were lower than in controls, whereas equol concentrations were similar. Compared with the reference group, gastric cancer risk decreased in the highest groups for genistein (OR, 0.54; 95% CI, 0.31-0.93) and daidzein (OR, 0.21; 95% CI, 0.08-0.58). Higher equol concentrations were associated with a decreased risk for gastric cancer (OR, 0.50; 95% CI, 0.27-0.90). The combination of the highest concentrations for each isoflavone category was associated with a 0.09-fold decreased risk for gastric cancer compared with the combination of the lowest concentrations for each category. There was no association between plasma lignan concentrations and gastric cancer. Conclusions: High serumconcentrations of isoflavones were associated with a decreased risk for gastric cancer. Impact: These results suggest a beneficial effect of high soybean product intake for gastric cancer risk. Cancer Epidemiol Biomarkers Prev; 19(5); 1292-300.(C)2010 AACR.Chun OK, 2009, J AM DIET ASSOC, V109, P245, DOI 10.1016/j.jada.2008.10.055Larkin T, 2008, CRIT REV FOOD SCI, V48, P538, DOI 10.1080/10408390701542716Iwasaki M, 2008, J CLIN ONCOL, V26, P1677, DOI 10.1200/JCO.2007.13.9964Zhou HB, 2008, WORLD J GASTROENTERO, V14, P627, DOI 10.3748/wjg.14.627XIAO CW, 2008, J NUTR, V138, P1244Hu C, 2007, FOOD CHEM TOXICOL, V45, P2219, DOI 10.1016/j.fct.2007.05.017Kurahashi N, 2007, CANCER EPIDEM BIOMAR, V16, P538, DOI 10.1158/1055-9965.EPI-06-0517Rice S, 2006, ENDOCR-RELAT CANCER, V13, P995, DOI 10.1677/erc.1.01159Chen YC, 2006, WORLD J GASTROENTERO, V12, P5972Gwack J, 2006, BRIT J CANCER, V95, P639, DOI 10.1038/sj.bjc.6603309Larsson SC, 2006, INT J CANCER, V119, P915, DOI 10.1002/ijc.21925Sauvaget C, 2005, CANCER CAUSE CONTROL, V16, P773, DOI 10.1007/s10552-005-5385-xNan HM, 2005, WORLD J GASTROENTERO, V11, P3175Shin A, 2005, BRIT J CANCER, V92, P1273, DOI 10.1038/sj.bjc.6602467YOO KY, 2005, ASIAN PAC J CANCER P, V6, P238Zhou HB, 2004, WORLD J GASTROENTERO, V10, P1822Verdrengh M, 2004, MICROBES INFECT, V6, P86, DOI 10.1016/j.micinf.2003.10.005Verdrengh M, 2003, INFLAMM RES, V52, P341, DOI 10.1007/s00011-003-1182-8Zubik L, 2003, AM J CLIN NUTR, V77, P1459Ito LS, 2003, ANN EPIDEMIOL, V13, P24, DOI 10.1016/S1047-2797(02)00269-7RIBOLI E, 2003, AM J CLIN NUTR, V78, P559Tsubono Y, 2003, J EPIDEMIOL, V13, pS125Sarkar FH, 2002, CANCER METAST REV, V21, P265, DOI 10.1023/A:1021210910821Nagata C, 2002, BRIT J CANCER, V87, P31, DOI 10.1038/sj.bjc.6600349Takezaki T, 2002, INT J CANCER, V99, P624, DOI 10.1002/ijc.10400Kim HJ, 2002, INT J CANCER, V97, P531, DOI 10.1002/ijc.10111YOO KY, 2002, ASIAN PAC J CANCER P, V3, P85Yamamoto S, 2001, J NUTR, V131, P2741Liggins J, 2000, BRIT J NUTR, V84, P717Wu AH, 2000, CANCER EPIDEM BIOMAR, V9, P1051Wang GJ, 2000, STEROIDS, V65, P339, DOI 10.1016/S0039-128X(00)00089-1Perera FP, 2000, CARCINOGENESIS, V21, P517Watanabe H, 1999, ONCOL REP, V6, P989Tatsuta M, 1999, INT J CANCER, V80, P396HUMFREY CDN, 1998, NAT TOXINS, V6, P51, DOI 10.1002/(SICI)1522-7189(199804)6:23.3.CO2-0MIKSICEK RJ, 1995, P SOC EXP BIOL MED, V208, P44SHEEHAN DM, 1995, P SOC EXP BIOL MED, V208, P3BAKER ME, 1995, P SOC EXP BIOL MED, V208, P131ADLERCREUTZ CHT, 1995, J NUTR, V125, P757MOLTENI A, 1995, J NUTR, V125, P751HONJO S, 1994, CANCER CAUSE CONTROL, V5, P285MATSUKAWA Y, 1993, CANCER RES, V53, P1328FRIEDMAN GD, 1992, CANCER EPIDEM BIOMAR, V1, P607HOSHIYAMA Y, 1992, CANCER CAUSE CONTROL, V3, P441ROSE DP, 1992, NUTRITION, V8, P47CHYOU PH, 1990, CANCER RES, V50, P7501SETCHELL KDR, 1988, MAMMALIAN LIGNANS PHMANTEL N, 1959, J NATL CANCER I, V719, P48