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Isoflavone and soy food intake and risk of lung cancer in never smokers: report from prospective studies in Japan and China

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Abstract

Purpose

Evidence from several cohorts has suggested that a higher intake of isoflavone is associated with lower risk of lung cancer in never smokers, but the association has not been investigated by histologic type of lung cancer. Adenocarcinoma is a common histologic type found in never smokers. We hypothesized that a higher intake of isoflavone is associated with a lower risk of lung adenocarcinoma among never smokers. Here, we examined the associations of isoflavone and soy food intake with lung cancer and its histologic types in never smokers.

Methods

We performed a pooled analysis using data from the Japan Public Health Center-based Prospective Study, Shanghai Women’s Health Study and Shanghai Men’s Study with 147,296 never smokers aged 40–74 years with no history of cancer. During 1,990,040 person-years of follow-up, 1247 lung cancer cases were documented. Dietary isoflavone and soy food intake were assessed using a food-frequency questionnaire. Multivariable Cox proportional hazards models assessed the associations between isoflavone and soy intake with incidence of lung cancer by histologic type.

Results

A higher intake of dietary isoflavone and soy food were associated with reduced risk of lung adenocarcinoma. The multivariable hazard ratios (HRs) (95% CI) of risk of lung adenocarcinoma for the highest versus lowest intakes of isoflavone and soy food were 0.74 (0.60–0.92) and 0.78 (0.63–0.96), respectively. The multivariable HRs of risk of lung adenocarcinoma associated with each 10 mg/day increase in isoflavone and each 50 g/day increase in soy food intake were 0.81 (0.70–0.94) and 0.84 (0.73–0.96), respectively.

Conclusion

Higher intake of isoflavone and soy food was associated with lower risk of lung adenocarcinoma in never smokers.

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Data availability

For information on how to submit an application for gaining access to JPHC data and/or biospecimens, please follow the instructions at https://epi.ncc.go.jp/en/jphc/805/8155.html.

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Acknowledgements

We are indebted to the Aomori, Akita, Iwate, Niigata, Nagano, Ibaraki, Osaka, Kochi, Nagasaki and Okinawa Cancer Registries for providing their incidence data. JPHC members are listed at the following site (as of April 2019); https://epi.ncc.go.jp/en/jphc/781/8390.html

Funding

This work was supported by National Cancer Center Research and Development Fund (23-A-31[toku], 26-A-2, 29-A-4, 2020-J-4) (since 2011); a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010); and the National Institute of Health (NIH) (UM1 CA173640 and UM1 CA182910).

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Authors and Affiliations

  1. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Choy-Lye Chei, Norie Sawada, Motoki Iwasaki, Taiki Yamaji, Taichi Shimazu, Manami Inoue & Shoichiro Tsugane

  2. Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA

    Nikhil K. Khankari

  3. Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, 37203, USA

    Hui Cai, Xiao-Ou Shu & Wei Zheng

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  1. Choy-Lye Chei
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  2. Norie Sawada
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  3. Nikhil K. Khankari
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  4. Motoki Iwasaki
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  7. Taichi Shimazu
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Contributions

NS, ST, MI, XOS and WZ contributed to study conception and designed the research. NS, ST, MI, TY, TS, MI, NKK, HC, XOS and WZ conducted the research. CLC and NS analyzed the data. The first draft of the manuscript was written by CLC and all the authors commented on previous versions of the manuscript. NS had primary responsibility for the final content. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Norie Sawada.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

The JPHC studies were approved by the institutional review board of the National Cancer Center, Japan. The SWHS and SMHS studies were approved by the institutional review boards for human research of both Shanghai Cancer Institute (China) and Vanderbilt University (United States).

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Informed consent was obtained from all the individual participants included in the study.

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Chei, CL., Sawada, N., Khankari, N.K. et al. Isoflavone and soy food intake and risk of lung cancer in never smokers: report from prospective studies in Japan and China. Eur J Nutr 62, 125–137 (2023). https://doi.org/10.1007/s00394-022-02968-y

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