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Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort

Aglago, Elom K. ; Huybrechts, Inge ; Murphy, Neil ; Casagrande, Corinne ; Nicolas, Genevieve ; Pischon, Tobias ; Fedirko, Veronika ; Severi, Gianluca ; Boutron-Ruault, Marie Christine and Fournier, Agnès , et al. (2020) In Clinical Gastroenterology and Hepatology 18(3). p.6-666
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiologic, Omega 3, Seafood, Tumorigenesis
in
Clinical Gastroenterology and Hepatology
volume
18
issue
3
pages
6 - 666
publisher
Elsevier
external identifiers
  • scopus:85079233777
  • pmid:31252190
ISSN
1542-3565
DOI
10.1016/j.cgh.2019.06.031
language
English
LU publication?
yes
id
b680c9c8-95d9-446e-881d-9f686830f1f0
date added to LUP
2020-02-20 12:58:04
date last changed
2024-06-12 09:24:51
@article{b680c9c8-95d9-446e-881d-9f686830f1f0,
  abstract     = {{<p>Background &amp; 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; P<sub>trend</sub> = .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82–0.98; P<sub>trend</sub> = .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83–1.00; P<sub>trend</sub> = .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; P<sub>trend</sub> = .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; P<sub>trend</sub> &lt; .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 (P<sub>heterogeneity</sub> = .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.</p>}},
  author       = {{Aglago, Elom K. and Huybrechts, Inge and Murphy, Neil and Casagrande, Corinne and Nicolas, Genevieve and Pischon, Tobias and Fedirko, Veronika and Severi, Gianluca and Boutron-Ruault, Marie Christine and Fournier, Agnès and Katzke, Verena and Kühn, Tilman and Olsen, Anja and Tjønneland, Anne and Dahm, Christina C. and Overvad, Kim and Lasheras, Cristina and Agudo, Antonio and Sánchez, Maria Jose and Amiano, Pilar and Huerta, José Maria and Ardanaz, Eva and Perez-Cornago, Aurora and Trichopoulou, Antonia and Karakatsani, Anna and Martimianaki, Georgia and Palli, Domenico and Pala, Valeria and Tumino, Rosario and Naccarati, Alessio and Panico, Salvatore and Bueno-de-Mesquita, Bas and May, Anne and Derksen, Jeroen W.G. and Hellstrand, Sophie and Ohlsson, Bodil and Wennberg, Maria and Van Guelpen, Bethany and Skeie, Guri and Brustad, Magritt and Weiderpass, Elisabete and Cross, Amanda J. and Ward, Heather and Riboli, Elio and Norat, Teresa and Chajes, Veronique and Gunter, Marc J.}},
  issn         = {{1542-3565}},
  keywords     = {{Epidemiologic; Omega 3; Seafood; Tumorigenesis}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{6--666}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Gastroenterology and Hepatology}},
  title        = {{Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort}},
  url          = {{http://dx.doi.org/10.1016/j.cgh.2019.06.031}},
  doi          = {{10.1016/j.cgh.2019.06.031}},
  volume       = {{18}},
  year         = {{2020}},
}