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

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Elom K Aglago, International Agency for Research on Cancer, France
  • Inge Huybrechts, International Agency for Research on Cancer, France
  • Neil Murphy, International Agency for Research on Cancer, France
  • Corinne Casagrande, International Agency for Research on Cancer, France
  • Genevieve Nicolas, International Agency for Research on Cancer, France
  • Tobias Pischon, Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany., Germany
  • Veronika Fedirko, Emory University, United States
  • Gianluca Severi, Universite Paris-Saclay, France
  • Marie-Christine Boutron-Ruault, Universite Paris-Saclay, France
  • Agnès Fournier, Universite Paris-Saclay, France
  • Verena Katzke, German Cancer Research Center, Germany
  • Tilman Kühn, German Cancer Research Center, Germany
  • Anja Olsen
  • Anne Tjønneland, University of Copenhagen, Danish Cancer Society, Denmark
  • Christina C Dahm
  • Kim Overvad
  • Cristina Lasheras, University of Oviedo, Spain
  • Antonio Agudo, L'Hospitalet de Llobregat, Spain
  • Maria-Jose Sánchez, Universidad de Granada, CIBER de Epidemiología y Salud Pública (CIBERESP), Spain., Spain
  • Pilar Amiano, BioDonostia Research Institute, Spain
  • José Maria Huerta, CIBER de Epidemiología y Salud Pública (CIBERESP), Spain., Murcia Regional Health Council, Spain
  • Eva Ardanaz, CIBER de Epidemiología y Salud Pública (CIBERESP), Spain., Navarra Public Health Institute, Navarra Institute for Health Research (IdsSNA), Pamplona, Spain., Spain
  • Aurora Perez-Cornago, University of Oxford, Oxford, United Kingdom
  • Antonia Trichopoulou, Hellenic Health Foundation., National and Kapodistrian University of Athens, Greece
  • Anna Karakatsani, National and Kapodistrian University of Athens, Aalborg University, International Agency for Research on Cancer, Greece
  • Georgia Martimianaki, Hellenic Health Foundation, Athens, Greece
  • Domenico Palli, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO., Italy
  • Valeria Pala, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy., Italy
  • Rosario Tumino, Cancer Registry and Histopathology Unit, "Civic - M.p.Arezzo" Hospital, ASP Ragusa, Italy., Italy
  • Alessio Naccarati, Italian Institute for Genomic Medicine, Turin, Italy., Italy
  • Salvatore Panico, Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy (BBdM)., Italy
  • Bas Bueno-de-Mesquita, National Institute for Public Health and the Environment (RIVM), University Medical Centre Utrecht, Imperial College London, University of Malaya, Netherlands
  • Anne May, University Medical Center Utrecht, Netherlands
  • Jeroen W G Derksen, University Medical Center Utrecht, Netherlands
  • Sophie Hellstrand, Lund University, Sweden
  • Bodil Ohlsson, Lund University, Sweden
  • Maria Wennberg, Umeå University, Sweden
  • Bethany Van Guelpen, Umeå University, Sweden
  • Guri Skeie, Arctic University of Norway, Norway
  • Magritt Brustad, Arctic University of Norway, Norway
  • Elisabete Weiderpass, International Agency for Research on Cancer (IARC-WHO), Lyon, France., Norway
  • Amanda J Cross, Imperial College London, United Kingdom
  • Heather Ward, Imperial College London, United Kingdom
  • Elio Riboli, Imperial College London, United Kingdom
  • Teresa Norat, Imperial College London, United Kingdom
  • Veronique Chajes, International Agency for Research on Cancer (IARC-WHO), Lyon, France., France
  • Marc J Gunter, International Agency for Research on Cancer

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.

Original languageEnglish
JournalClinical Gastroenterology and Hepatology
Volume18
Issue3
Pages (from-to)654-666.e6
Number of pages19
ISSN1542-3565
DOIs
Publication statusPublished - Mar 2020

    Research areas

  • epidemiologic, omega 3, seafood, tumorigenesis

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