Cancer Causes & Control

, Volume 30, Issue 5, pp 527–535 | Cite as

Flavonoids and bladder cancer risk

  • Marta Rossi
  • Panagiota Strikoudi
  • Maria-Eleni Spei
  • Maria Parpinel
  • Diego Serraino
  • Maurizio Montella
  • Massimo Libra
  • Carlo La Vecchia
  • Valentina RosatoEmail author
Original Paper



Flavonoids have drawn attention because of their antioxidant capacity and anti-carcinogenic effect in various types of cancer. A limited number of studies has investigated their potential effect on the risk of bladder cancer, with inconsistent results.


We analyzed data from an Italian case–control study including 690 incident bladder cancer cases and 665 controls admitted to the same network of hospitals for acute, non-neoplastic, non tobacco-related diseases. Subjects were interviewed using a reproducible and validated food-frequency questionnaire. We applied data on food and beverage composition to estimate the intake of isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones and flavonols. We estimated odds ratios (ORs) through multiple logistic regression models, including terms for potential confounding factors, including tobacco smoking and total energy intake.


We found an inverse association between isoflavones (OR for the highest compared to the lowest quintile of intake = 0.56, 95% CI 0.37–0.84) and flavones (OR = 0.64, 95% CI 0.44–0.95) and bladder cancer. Non-significant inverse association was found for flavan-3-ols (OR = 0.70), flavonols (OR = 0.85) and total flavonoids (OR = 0.76). The results were consistent for non-muscle-invasive and muscle-invasive bladder cancers.


Our data indicate an inverse association between isoflavones and flavones with respect to bladder cancer risk.


Case–control study Bladder cancer Flavonoids Risk factors 



This work was supported by the Italian Association for Cancer Research (AIRC) (My First AIRC Grant No. 17070). V.R. was supported by a fellowship from the Italian Foundation for Cancer Research (FIRC No. 18107). We also acknowledge the Lega Italiana per la Lotta contro i Tumori Sede Centrale for the contribution on the 5/1000 Project, 2015.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10552_2019_1158_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
  2. 2.Department of Nutrition and Dietetics, Faculty of Agriculture Technology, Food Technology and NutritionAlexander Technological Educational Institution of ThessalonikiSindos, ThessalonikiGreece
  3. 3.Department of Hygiene, Epidemiology, and Medical Statistics, School of MedicineNational and Kapodistrian University of AthensGoudi, AthensGreece
  4. 4.Department of MedicineUniversità degli Studi di UdineUdineItaly
  5. 5.Cancer Epidemiology UnitIstituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro di Riferimento OncologicoAviano (PN)Italy
  6. 6.Unit of EpidemiologyIstituto Nazionale Tumori Fondazione G. PascaleNapoliItaly
  7. 7.Section of Oncologic, Clinic and General Pathology, Department of Biomedical & Biotechnological SciencesUniversità degli Studi di CataniaCataniaItaly
  8. 8.Unit of Medical Statistics and BiometryFondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanoItaly

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