Cancer Causes & Control

, Volume 17, Issue 2, pp 169–180 | Cite as

Dietary Phytoestrogen, Serum Enterolactone and Risk of Prostate Cancer: The Cancer Prostate Sweden Study (Sweden)

  • Maria Hedelin
  • Åsa Klint
  • Ellen T. Chang
  • Rino Bellocco
  • Jan-Erik Johansson
  • Swen-Olof Andersson
  • Satu-Maarit Heinonen
  • Herman Adlercreutz
  • Hans-Olov Adami
  • Henrik Grönberg
  • Katarina Augustsson Bälter
Original Paper



Based on evidence that phytoestrogens may protect against prostate cancer, we evaluated the associations between serum enterolactone concentration or dietary phytoestrogen intake and risk of prostate cancer.


In our Swedish population-based case-control study, questionnaire-data were available for 1,499 prostate cancer cases and 1,130 controls, with serum enterolactone levels in a sub-group of 209 cases and 214 controls. Unconditional logistic regression was performed to estimate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with risk of prostate cancer.


High intake of food items rich in phytoestrogens was associated with a decreased risk of prostate cancer. The OR comparing the highest to the lowest quartile of intake was 0.74 (95% CI: 0.57–0.95; p-value for trend: 0.01). In contrast, we found no association between dietary intake of total or individual lignans or isoflavonoids and risk of prostate cancer. Intermediate serum levels of enterolactone were associated with a decreased risk of prostate cancer. The ORs comparing increasing quartiles of serum enterolactone concentration to the lowest quartile were, respectively, 0.28 (95% CI: 0.15–0.55), 0.63 (95% CI: 0.35–1.14) and 0.74 (95% CI: 0.41–1.32).


Our results support the hypothesis that certain foods high in phytoestrogens are associated with a lower risk of prostate cancer.


Diet Enterolactone Epidemiology Lignans Phytoestrogen Prostate cancer 



body mass index


confidence interval




odds ratio


prostate-specific antigen





The authors thank all study participants in the CAPS study; Ulrika Lund for skillfully coordinating the study center at Karolinska Institute; Lotta Spångberg, Berit Andersson and Britt Eriksson for well done interviews; all urologists including their patients in the CAPS study; and all urologists providing clinical data to the national registry of prostate cancer. We also thank Karin Andersson, Susan Lindh, Gabriella Thorén-Berglund and Margareta Åswärd at the Regional Cancer Registries in Umeå, Uppsala, Stockholm-Gotland and Linköping, respectively. In addition, we thank Sören Holmgren and the personnel at the Medical Biobank in Umeå for skillfully handling the blood samples.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Maria Hedelin
    • 1
  • Åsa Klint
    • 1
  • Ellen T. Chang
    • 1
  • Rino Bellocco
    • 1
  • Jan-Erik Johansson
    • 2
  • Swen-Olof Andersson
    • 2
  • Satu-Maarit Heinonen
    • 3
  • Herman Adlercreutz
    • 3
  • Hans-Olov Adami
    • 1
  • Henrik Grönberg
    • 4
  • Katarina Augustsson Bälter
    • 1
  1. 1.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  2. 2.Department of UrologyÖrebro University Hospital and Center for Assessment of Medical TechnologyÖrebroSweden
  3. 3.Institute for Preventive Medicine, Nutrition and Cancer, Folkhälsan Research Center and Division of Clinical ChemistryUniversity of HelsinkiHelsinkiFinland
  4. 4.Department of Radiation Sciences/OncologyUmeå UniversityUmeåSweden

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