***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND It is uncertain whether or not vegetables , fruit , or grains protect against colorectal cancer . OBJECTIVE In a large prospect i ve study , we investigated the association of vegetable , fruit , and grain intakes with  colorectal cancer risk . DESIGN Between 1993 and 1996 , 85 903 men and 105 108 women completed a quantitative food-frequency question naire  that included approximately 180 foods and beverages in the Multiethnic Cohort Study . A diagnosis of colorectal cancer was made in 1138 men and 972 women after an average follow-up of 7.3 y. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95 % CIs for colorectal cancer . RESULTS In men , multivariate adjustment for energy intake , dietary , and nondietary variables result ed in relative risks in the highest quintile group of 0.74 ( 95 % CI : 0.59 , 0.93 ; P for trend = 0.02 ) for vegetables and fruit combined , 0.80 ( 95 % CI : 0.64 , 0.99 ; P for trend = 0.09 ) for fruit alone , and 0.85 ( 95 % CI : 0.69 , 1.05 ; P for trend = 0.05 ) for vegetables alone . When colon and rectal cases were separated among men , the inverse associations were stronger for colon than for rectal cancer . In women , none of the associations with vegetables , fruit , or vegetables and fruit combined were significant .  Grain intake  was not associated with colorectal cancer for either men or women . CONCLUSION The intake of vegetables and fruit was inversely related to colorectal cancer risk among men but not among women . The association appears stronger for colon than for rectal cancer BACKGROUND Soy isoflavones have numerous biological properties that suggest that they may protect against colorectal cancer . Colorectal epithelial cell proliferation has been used extensively as an intermediate endpoint biomarker for colorectal neoplasia . OBJECTIVE We tested the hypothesis that supplementation with soy protein containing isoflavones decreases colorectal epithelial cell proliferation . DESIGN A 12-mo r and omized intervention was conducted in men and women aged 50 - 80 y with recently diagnosed adenomatous polyps . One hundred fifty participants were enrolled and r and omly assigned to an active treatment group ( 58 g protein powder/d containing 83 mg isoflavones/d ; + ISO ) or a control group ( ethanol-extracted soy-protein powder containing 3 mg isoflavones ; -ISO ) . Biopsy specimens from the cecum , sigmoid colon , and rectum were collected at baseline and at the 12-mo follow-up . Ki-67 antibody immunohistostaining was used to detect cell proliferation . One hundred twenty-five participants completed the study , and  proliferation  was measured in the first 91 who completed the study . RESULTS In the sigmoid colon , cell proliferation increased by 0.9 ( 95 % CI : 0.09 , 1.9 ) labeled nuclei per crypt more ( 11 % ) in the + ISO group than in the -ISO group over the 12-mo intervention , which was opposite the direction predicted . The number of labeled nuclei per 100 mum crypt height also increased more in the + ISO than in the -ISO group . In the cecum and sigmoid colon , but not in the rectum , the proliferation count increased as the serum genistein concentration increased . Proliferation distribution and crypt height were not changed by treatment at any site . CONCLUSIONS Supplementation with soy protein containing isoflavones does not reduce colorectal epithelial cell proliferation or the average height of proliferating cells in the cecum , sigmoid colon , and rectum and increases cell proliferation measures in the sigmoid colon 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 aim ed 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 r and om-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 data bases , flavonoid intake was estimated from participant responses to a 117-item food-frequency question naire ( 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 BACKGROUND A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer ( CRC ) . However , the findings to date are inconsistent . OBJECTIVE We examined the relation between self-reported usual consumption of fruit and vegetables  and the incidence of CRC . DESIGN In the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) , 452,755 subjects ( 131,985 men and 320,770 women ) completed a dietary question naire in 1992 - 2000 and were followed up for cancer incidence and mortality until 2006 . A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios ( HRs ) and 95 % CIs . RESULTS After an average follow-up of 8.8 y , 2,819 incident CRC cases were reported . Consumption of fruit and vegetables  was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption ( HR : 0.86 ; 95 % CI : 0.75 , 1.00 ; P for trend = 0.04 ) , particularly with colon cancer risk ( HR : 0.76 ; 95 % CI : 0.63 , 0.91 ; P for trend < 0.01 ) . Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption : HRs of 0.95 ( 95 % CI : 0.91 , 1.00 ; P = 0.04 ) and 0.94 ( 95 % CI : 0.89 , 0.99 ; P = 0.02 ) , respectively . The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers , but positive in current smokers . This modifying effect was found for fruit and vegetables combined and for vegetables alone ( P for interaction < 0.01 for both ) . CONCLUSIONS These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC , especially of colon cancer . This effect may depend on smoking status BACKGROUND Flavopiridol , a synthetic flavone that inhibits cell cycle progression , has demonstrated activity in colon cancer in xenografts and in a phase I trial . We evaluated flavopiridol in a phase II trial in patients with previously untreated advanced colorectal cancer ( ACRC ) . PATIENTS AND METHODS Twenty chemotherapy-naïve patients with ACRC received flavopiridol at a dose of 50 mg/m(2)/day via a 72-h continuous infusion every 14 days . Response was assessed by computed tomography or magnetic resonance imaging every 8 weeks . RESULTS Twenty patients were enrolled ; 19 were evaluable for toxicity and 18 for response . There were no objective responses . Five patients had stable disease lasting a median of 7 weeks . The median time to progression was 8 weeks . Median survival was 65 weeks . The principal grade 3/4 toxicities were diarrhea , fatigue and hyperglycemia , occurring in 21 % , 11 % and 11 % of patients , respectively . Other common toxicities included anemia , anorexia and nausea/vomiting . CONCLUSIONS Flavopiridol in this dose and schedule does not have single-agent activity in patients with ACRC . Recent pre clinical data suggest that flavopiridol enhances apoptosis when combined with chemotherapy . Trials that evaluate flavopiridol in combination with active cytotoxic drugs should help to define the role of this novel agent in ACRC Several experimental studies have reported that the anticarcinogenic properties of dietary soy play an important role in preventing colorectal cancer . However , few epidemiologic studies have examined this association in general population s and their findings have been inconsistent . We investigated the association between dietary soy and isoflavone intake and incidence of colorectal cancer in a prospect i ve cohort study of 83,063 Japanese men and women , ages 45 to 74 years .  Dietary soy and isoflavone intake was measured through a vali date d food frequency question naire in 1995 and 1998 . Throughout 2004 , a total of 886 cases of colorectal cancer were newly identified ( 291 proximal colon , 286 distal colon , and 277 rectum ) . The hazard ratios and 95 % confidence intervals ( 95 % CIs ) were estimated by fitting a Cox proportional hazards model . The intake of isoflavones , miso soup , and soy food was not associated with colorectal cancer in either men or women . By colorectal cancer subsite , the risk of proximal colon cancer in men decreased with increasing consumption of isoflavones , miso soup , and soy food . Compared with men in the lowest quartiles of isoflavones , miso soup , and soy food intake , the hazard ratios in the highest quartiles were 0.55 ( 95 % CI , 0.33 - 0.92 ) , 0.72 ( 95 % CI , 0.43 - 1.21 ) , and 0.51 ( 95 % CI , 0.30 - 0.87 ) , respectively . The results showed no association for distal colon and rectal cancer in men or for subsites of colorectal cancer in women . These findings suggest that the intake of isoflavones , miso soup , and soy food has no substantial effect on the  risk of colorectal cancer in Japanese men and women . ( Cancer Epidemiol Biomarkers Prev 2008;17(8):2128–35 BACKGROUND & AIMS Familialadenomatous polyposis ( FAP ) is an autosomal-dominant disorder characterized by the development of hundreds of colorectal adenomas and eventual colorectal cancer . Regression of adenomas in this syndrome occurs with the administration of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors , but these compounds can have considerable side effects . We evaluated the efficacy of the combination of diet-derived nonprescription supplements curcumin and quercetin to regress adenomas in patients with FAP . METHODS Five FAP patients with prior colectomy ( 4 with retained rectum and 1 with an ileal anal pouch ) received curcumin 480 mg and quercetin 20 mg orally 3 times a day . The number and size of polyps were assessed at baseline and after therapy . The  Wilcoxon signed-rank test was used to determine differences in the number and size of polyps . Treatment side effects and medication compliance also were evaluated . RESULTS All 5 patients had a decreased polyp number and size from baseline after a mean of 6 months of treatment with curcumin and quercetin . The mean percent decrease in the number and size of polyps from baseline was 60.4 % ( P < .05 ) and 50.9 % ( P < .05 ) , respectively . Minimal adverse side effects and no laboratory abnormalities were noted . CONCLUSIONS The combination of curcumin and quercetin appears to reduce the number and size of ileal and rectal adenomas in patients with FAP without appreciable toxicity . R and omized controlled trials are needed to vali date these findings In vitro and in vivo laboratory data point to chemoprotective effects of flavonoids on  colorectal cancer .  However , there has been limited epidemiologic research on the dietary intake of flavonoids and risk of  colorectal cancer .  Recent expansions of dietary data bases 
    Output:
    
There was no evidence that total flavonoid intake reduced the risk of colorectal neoplasms .
A statistically significant reduced risk of CRC was found with high intake of epicatechin .
There was medium quality evidence to support that increased intake of procyanidin and phytoestrogen could reduced the incidence of CRC .
There was no evidence that suggested that high anthocyanin intake had an inverse association with colorectal adenomas .
AUTHORS ' CONCLUSIONS There is insufficient and conflicting evidence regarding flavonoid intake and the prevention of colorectal neoplasms .
It is difficult to determine flavonoid intake .