Evidence map›Paper›PMID 37011765›Full record

ArticleThe American journal of clinical nutrition2023

Flavonoid intake and survival after diagnosis of colorectal cancer: a prospective study in 2 US cohorts.

Shanshan Shi, Kai Wang, Rong Zhong, Aedín Cassidy, Eric B Rimm, Katharina Nimptsch, Kana Wu, Andrew T Chan, Edward L Giovannucci, Shuji Ogino and 3 more

Abstract read
In one paragraph

Article in The American journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. The impact of different dietary flavonoids on the risk of coronary heart disease in cancer patients and that on the prognosis of patients with cancer and coronary heart disease.European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2025
    Article
  6. Review
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Shanshan ShiDepartment of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Kai WangDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Rong ZhongDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Aedín CassidyInstitute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom.
Eric B RimmDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Katharina NimptschDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Kana WuDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Andrew T ChanChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, United States; Broad Institute of MIT and Harvard, Cambridge, MA, United States.
Edward L GiovannucciDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Shuji OginoDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Broad Institute of MIT and Harvard, Cambridge, MA, United States; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States.
Kimmie NgDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States.
Jeffrey A MeyerhardtDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States.
Mingyang SongDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, United States. Electronic address: mis911@mail.harvard.edu.

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, TAMIMI, RULLA M · 2000 to 2019
$77.8M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Accelerating Transdisciplinary Epidemiology of Colorectal CancerR35CA197735 · NCI · DANA-FARBER CANCER INST · PI OGINO, SHUJI · 2015 to 2021
$6.0M
Coffee and metabolites modulating the gut microbiome for improved colorectal cancer survivalR01CA263776 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Mingyang Song · 2022 to 2026
$3.3M
The Gut Microbiome, Lifestyle, and Colorectal NeoplasiaU01CA261961 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Mingyang Song · 2022 to 2026
$3.0M
Marine Omega-3 Polyunsaturated Fatty Acid, Gut Microbiome, and Colorectal Cancer PreventionR00CA215314 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI SONG, MINGYANG · 2018 to 2020
$679k
NCI NIH HHS P01 CA087969NCI NIH HHS R00 CA215314NCI NIH HHS R01 CA263776NCI NIH HHS R35 CA197735NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA261961NCI NIH HHS UM1 CA186107
6 · The paper itself

Abstract

backgroundAlthough experimental evidence supports anticancer effects of flavonoids, the influence of flavonoid intake on colorectal cancer (CRC) survival remains unknown.

objectivesThis study aimed to assess the association of postdiagnostic flavonoid intake with mortality.

methodsWe prospectively assessed the association of postdiagnostic flavonoid intake with CRC-specific and all-cause mortality in 2552 patients diagnosed with stage I-III CRC in 2 cohort studies-the Nurses' Health Study and the Health Professionals Follow-up Study. We assessed the intake of total flavonoids and their subclasses using validated food frequency questionnaires. We used the inverse probability-weighted multivariable Cox proportional hazards regression model to calculate the hazard ratio (HR) of mortality after adjusting for prediagnostic flavonoid intake and other potential confounders. We performed spline analysis to evaluate dose-response relationships.

resultsThe mean [standard deviation (SD)] age of patients at diagnosis was 68.7 (9.4) y. During 31,026 person-y of follow-up, we documented 1689 deaths, of which 327 were due to CRC. The total flavonoid intake was not associated with mortality, but a higher intake of flavan-3-ols was suggestively associated with lower CRC-specific and all-cause mortality, with multivariable HR (95% CI) per 1-SD increases of 0.83 (0.69-0.99; P = 0.04) and 0.91 (0.84-0.99; P = 0.02), respectively. The spline analysis showed a linear relationship between postdiagnostic flavan-3-ol intake and CRC-specific mortality (P = 0.01 for linearity). As the major contributor to flavan-3-ol intake, tea showed an inverse association with CRC-specific and all-cause mortality, with multivariable HRs per 1 cup/d of tea of 0.86 (0.75-0.99; P = 0.03) and 0.90 (0.85-0.95; P < 0.001), respectively. No beneficial associations were found for other flavonoid subclasses.

conclusionsHigher intake of flavan-3-ol after CRC diagnosis was associated with lower CRC-specific mortality. Small, readily achievable increases in the intake of flavan-3-ol-rich foods, such as tea, may help improve survival in patients with CRC.

Indexed as

Colorectal NeoplasmsFlavonoidsDietFollow-Up StudiesHumansProspective StudiesTeaFlavonoidsTeacolorectal cancerflavan-3-olflavonoidssurvivaltea

Identifiers

PMID37011765
PMCPMC10447476

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.