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Dietary flavonoid intake and non-Hodgkin lymphoma risk^1,2,3

¹ From the Division of Cancer, Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (CLF, LMM, PH, and MHW); the Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN (JRC); the Keck School of Medicine, University of Southern California, Los Angeles, CA (WC); the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, and the University of Washington School of Public Health and Community Medicine, Seattle, WA (SD); the Department of Family Medicine, Wayne State University, and the Karmanos Cancer Institute, Detroit, MI (MS)

Background: The role of dietary factors in non-Hodgkin lymphoma (NHL) risk is not yet well understood. Dietary flavonoids are polyphenolic compounds proposed to be anticarcinogenic. Flavonoids are well-characterized antioxidants and metal chelators, and certain flavonoids exhibit antiproliferative and antiestrogenic effects.

Objective: We aimed to evaluate the hypothesis that higher flavonoid intake is associated with lower NHL risk.

Design: During 1998–2000, we identified incident NHL cases aged 20–74 y from 4 US Surveillance, Epidemiology, and End Results cancer registries. Controls without history of NHL were selected by random-digit dialing or from Medicare files and frequency-matched to cases by age, center, race, and sex. Using 3 recently developed US Department of Agriculture nutrient-specific databases, flavonoid intake was estimated from participant responses to a 117-item food-frequency questionnaire (n = 466 cases and 390 controls). NHL risk in relation to flavonoid intake in quartiles was evaluated after adjustment for age, sex, registry, education, NHL family history, and energy intake.

Results: Higher total flavonoid intake was significantly associated with lower risk of NHL (P for trend < 0.01): a 47% lower risk in the highest quartile of intake than in the lowest (95% CI: 31%, 73%). Higher intakes of flavonols, epicatechins, anthocyanidins, and proanthocyanidins were each significantly associated with decreased NHL risk. Similar patterns of risk were observed for the major NHL subtypes—diffuse large B-cell lymphoma (n = 167) and follicular lymphoma (n = 146).

Conclusion: A higher intake of flavonoids, dietary components with several putative anticarcinogenic activities, may be associated with lower NHL risk.

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