TY - JOUR
T1 - Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort
AU - Aglago, Elom K
AU - Huybrechts, Inge
AU - Murphy, Neil
AU - Casagrande, Corinne
AU - Nicolas, Genevieve
AU - Pischon, Tobias
AU - Fedirko, Veronika
AU - Severi, Gianluca
AU - Boutron-Ruault, Marie-Christine
AU - Fournier, Agnès
AU - Katzke, Verena
AU - Kühn, Tilman
AU - Olsen, Anja
AU - Tjønneland, Anne
AU - Dahm, Christina C
AU - Overvad, Kim
AU - Lasheras, Cristina
AU - Agudo, Antonio
AU - Sánchez, Maria-Jose
AU - Amiano, Pilar
AU - Huerta, José Maria
AU - Ardanaz, Eva
AU - Perez-Cornago, Aurora
AU - Trichopoulou, Antonia
AU - Karakatsani, Anna
AU - Martimianaki, Georgia
AU - Palli, Domenico
AU - Pala, Valeria
AU - Tumino, Rosario
AU - Naccarati, Alessio
AU - Panico, Salvatore
AU - Bueno-de-Mesquita, Bas
AU - May, Anne
AU - Derksen, Jeroen W G
AU - Hellstrand, Sophie
AU - Ohlsson, Bodil
AU - Wennberg, Maria
AU - Van Guelpen, Bethany
AU - Skeie, Guri
AU - Brustad, Magritt
AU - Weiderpass, Elisabete
AU - Cross, Amanda J
AU - Ward, Heather
AU - Riboli, Elio
AU - Norat, Teresa
AU - Chajes, Veronique
AU - Gunter, Marc J
PY - 2020
Y1 - 2020
N2 - BACKGROUND & AIMS: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.METHODS: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs.RESULTS: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80-0.96; Ptrend=.005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82-0.98; Ptrend=.009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83-1.00; Ptrend=.016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78-0.95; Ptrend=.010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18-1.45; Ptrend<.001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (Pheterogeneity=.026).CONCLUSIONS: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.
AB - BACKGROUND & AIMS: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.METHODS: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs.RESULTS: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80-0.96; Ptrend=.005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82-0.98; Ptrend=.009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83-1.00; Ptrend=.016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78-0.95; Ptrend=.010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18-1.45; Ptrend<.001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (Pheterogeneity=.026).CONCLUSIONS: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.
KW - Epidemiologic
KW - Omega 3
KW - Seafood
KW - Tumorigenesis
UR - http://www.scopus.com/inward/record.url?scp=85079233777&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2019.06.031
DO - 10.1016/j.cgh.2019.06.031
M3 - Journal article
C2 - 31252190
SN - 1542-3565
VL - 18
SP - 654-666.e6
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 3
ER -