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Circulating isoflavone and lignan concentrations and prostate cancer risk : a meta-analysis of individual participant data from seven prospective studies including 2,828 cases and 5,593 controls

  • Aurora Perez-Cornago
  • Paul N. Appleby
  • Heiner Boeing
  • Leire Gil
  • Cecilie Kyrø
  • Fulvio Ricceri
  • Neil Murphy
  • Antonia Trichopoulou
  • Konstantinos K. Tsilidis
  • Kay Tee Khaw
  • Robert N. Luben
  • Randi E. Gislefoss
  • Hilde Langseth
  • Isabel Drake
  • Emily Sonestedt
  • Peter Wallström
  • Pär Stattin
  • Anders Johansson
  • Rikard Landberg
  • Lena Maria Nilsson
  • Kotaro Ozasa
  • Akiko Tamakoshi
  • Kazuya Mikami
  • Tatsuhiko Kubo
  • Norie Sawada
  • Shoichiro Tsugane
  • Timothy J. Key
  • Naomi E. Allen
  • Ruth C. Travis
Publishing year: 2018-01-01
Language: English
Pages: 2677-2686
Publication/Series: International Journal of Cancer
Volume: 143
Issue: 11
Document type: Journal article
Publisher: John Wiley and Sons Inc.

Abstract english

Phytoestrogens may influence prostate cancer development. This study aimed to examine the association between prediagnostic circulating concentrations of isoflavones (genistein, daidzein, equol) and lignans (enterolactone and enterodiol) and the risk of prostate cancer. Individual participant data were available from seven prospective studies (two studies from Japan with 241 cases and 503 controls and five studies from Europe with 2,828 cases and 5,593 controls). Because of the large difference in circulating isoflavone concentrations between Japan and Europe, analyses of the associations of isoflavone concentrations and prostate cancer risk were evaluated separately. Prostate cancer risk by study-specific fourths of circulating concentrations of each phytoestrogen was estimated using multivariable-adjusted conditional logistic regression. In men from Japan, those with high compared to low circulating equol concentrations had a lower risk of prostate cancer (multivariable-adjusted OR for upper quartile [Q4] vs. Q1 = 0.61, 95% confidence interval [CI] = 0.39–0.97), although there was no significant trend (OR per 75 percentile increase = 0.69, 95 CI = 0.46–1.05, ptrend = 0.085); Genistein and daidzein concentrations were not significantly associated with risk (ORs for Q4 vs. Q1 = 0.70, 0.45–1.10 and 0.71, 0.45–1.12, respectively). In men from Europe, circulating concentrations of genistein, daidzein and equol were not associated with risk. Circulating lignan concentrations were not associated with the risk of prostate cancer, overall or by disease aggressiveness or time to diagnosis. There was no strong evidence that prediagnostic circulating concentrations of isoflavones or lignans are associated with prostate cancer risk, although further research is warranted in populations where isoflavone intakes are high.


  • Cancer and Oncology
  • isoflavones
  • lignans
  • phytoestrogens
  • pooled analysis
  • prostate cancer risk


  • Diabetes - Cardiovascular Disease
  • Nutrition Epidemiology
  • ISSN: 0020-7136
Emily Sonestedt
E-mail: emily [dot] sonestedt [at] med [dot] lu [dot] se

Associate senior lecturer

Nutrition Epidemiology

+46 40 39 13 25

+46 73 700 71 45


Jan Waldenströms gata 35, CRC 60:13, Malmö


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