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ABSTRACT: Urinary Excretion of Phytoestrogens and Risk of Breast
Cancer among Chinese Women in Shanghai
Although the majority of ecological and experimental studies have
suggested a potential role of phytoestrogens in breast cancer
prevention, findings from epidemiological studies have been inconsistent.
Part of the inconsistencies may be attributable to the difficulty
in measuring intake levels of phytoestrogens. Overnight urine
samples from 250 incident breast cancer cases and their individually
matched controls were analyzed for urinary excretion rates of
isoflavonoids, mammalian lignans, and citrus flavonoids.
The
study subjects were a subset of the participants in the Shanghai
Breast Cancer Study, a large population-based case-control study
conducted in Shanghai from 1996-1998.
To minimize potential
influence of treatment on the exposure of interest, urine samples
from breast cancer cases were collected before cancer therapy.
Urinary excretion of total isoflavonoids and mammalian lignans
was substantially lower in breast cancer cases than in controls.
The median excretion rate of total isoflavonoids was 13.97 nmol/mg
creatinine in cases and 23.09 in controls (P = 0.01), and the
median excretion rate of total lignans was 1.77 in cases and
4.16 in controls (P < 0.01). The risk of breast cancer was
reduced with increasing excretion of total isoflavonoids (P for
trend, 0.04) and total lignans (P for trend, <0.01), with
adjusted odds ratios of 0.62 (95% confidence interval, 0.39-0.99)
and 0.40 (95% confidence interval, 0.24-0.64) observed for
the highest versus the lowest tertile of total isoflavonoid and
lignan excretion, respectively. The adjusted odds ratio was 0.28
(95% confidence interval, 0.15-0.50) for women who had a
high excretion rate of both total lignans and isoflavonoids compared
with those with a low excretion of both groups of phytoestrogens.
No association was observed with citrus flavonoids.
The results
from this study suggest that high intake of certain phytoestrogens
may reduce the risk of breast cancer.
[09/11/2002; Cancer Epidemiology, Biomarkers and Prevention]
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