TABLE 3.
HRs (95% CIs) for the association between intakes of total flavonoids, flavonols, and flavanones and incident epithelial ovarian cancer by histologic subtype and tumor aggressiveness in the NHS and NHSII1
| Histologic subtypes (n = 723) |
Tumor aggressiveness (n = 668) |
|||||
| Serous and poorly differentiated (n = 446) | Nonserous (n = 277) | P-heterogeneity | Rapidly fatal (n = 261) | Less aggressive (n = 407) | P-heterogeneity | |
| Total flavonoids | 0.49 | |||||
| HR (95% CI) | 0.82 (0.60, 1.13) | 0.86 (0.58, 1.27) | — | 0.71 (0.47, 1.06) | 0.88 (0.63, 1.22) | |
| P-trend | 0.22 | 0.32 | 0.98 | 0.09 | 0.28 | |
| Flavonols | 0.78 | |||||
| HR (95% CI) | 0.75 (0.54, 1.03) | 0.70 (0.47, 1.03) | — | 0.70 (0.47, 1.05) | 0.74 (0.53, 1.04) | |
| P-trend | 0.15 | 0.20 | 0.92 | 0.19 | 0.21 | |
| Flavanones | 0.94 | |||||
| HR (95% CI) | 0.68 (0.50, 0.92) | 1.04 (0.72, 1.50) | — | 0.83 (0.57, 1.22) | 0.77 (0.56, 1.05) | |
| P-trend | 0.07 | 0.53 | 0.10 | 0.49 | 0.33 | |
HRs for comparison of highest with lowest quintiles stratified by age, calendar time, and cohort and adjusted for the duration of oral contraceptive use, parity, history of tubal ligation, history of hysterectomy, duration of postmenopausal hormone use by type, family history of breast or ovarian cancer, and quintiles of energy-adjusted lactose, caffeine, and total energy intakes. Tumor aggressiveness was defined as rapidly fatal within 3 y of ovarian cancer diagnosis. To allow ≥3 y postdiagnostic follow-up, the endpoint for rapidly fatal ovarian cancer was June 2008 for the NHS and June 2009 for the NHSII, respectively. Cox proportional hazards models were used to estimate HRs, and median values in each quintile were used to test for a linear trend. A random-effects meta-analysis method was used for the test of heterogeneity. NHS, Nurses’ Health Study; NHSII, Nurses’ Health Study II.