American Journal of Epidemiology Advance Access originally published online on September 6, 2007
American Journal of Epidemiology 2007 166(10):1116-1125; doi:10.1093/aje/kwm197
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Fish Consumption, n-3 Fatty Acids, and Colorectal Cancer: A Meta-Analysis of Prospective Cohort Studies
1 Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
2 Wageningen UR Library, Wageningen University and Research Centre, Wageningen, The Netherlands
3 Mathematical and Statistical Methods Group, Wageningen University, Wageningen, The Netherlands
Correspondence to Dr. Anouk Geelen, Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, the Netherlands (e-mail: anouk.geelen{at}wur.nl).
Received for publication January 30, 2007. Accepted for publication June 1, 2007.
Animal studies show favorable effects of n-3 fatty acids on inflammation and cancer, but results from epidemiologic studies appear to be inconsistent. The authors conducted meta-analyses of prospective cohort studies that evaluated the association between fish consumption or n-3 fatty acids and colorectal cancer incidence or mortality. Random-effects models were used, and heterogeneity between study results was explored through stratified analyses. The pooled relative risks for the highest compared with the lowest fish consumption category were 0.88 (95% confidence interval: 0.78, 1.00) for colorectal cancer incidence (14 studies) and 1.02 (95% confidence interval: 0.90, 1.16) for colorectal cancer mortality (four studies). The pooled relative risks for colorectal cancer incidence were 0.96 (95% confidence interval: 0.92, 1.00) for each extra occurrence of fish consumption per week (seven studies) and 0.97 (95% confidence interval: 0.92, 1.03) for each extra 100 g of fish consumed per week (four studies). Stratified analysis showed that the pooled relative risk for colorectal cancer incidence was more pronounced for women and in studies with a large exposure contrast. In cohort studies, fish consumption was shown to slightly reduce colorectal cancer risk. Existing evidence that n-3 fatty acids inhibit colorectal carcinogenesis is in line with these results, but few data are available addressing this association.
cohort studies; colorectal neoplasms; fatty acids, omega-3; fishes; meta-analysis
Abbreviations: CI, confidence interval
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