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

Abstract

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 trend [ .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82-0.98; P trend [ .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83-1.00; P trend [ .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 trend [ .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 trend < .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 heterogeneity [ .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.

Consumption and physico‐chemical characteristics of smoked and smoked‐dried fish commonly produced in South Benin and contribution to recommended nutrient intakes

“…According to Albert et al (2002), regular consumption of omega-3 PUFA contained in fish reduces the risk of sudden death related to cardiovascular illness. Fish consumption is also associated with reduction of death from coronary heart disease and reduction of colorectal cancer (Aglago et al, 2020;Clifton & Keogh, 2017).…”

“…Due to their nutritional quality, fish consumption results in important nutritional intake necessary for human health (Amoussou et al, 2019). Indeed, fish consumption is associated with reduction of death from coronary heart disease and reduction of colorectal cancer (Aglago et al, 2020;Clifton & Keogh, 2017). Although several studies were carried out on smoked fish and smoked-dried fish (Adeyeye, Oyewole, Obadina, & Omemu, 2015;Amos & Paulina, 2017;Anihouvi et al, 2019;Assogba et al, 2019;Olayemi, Raji, & Adedayo, 2012), to our best knowledge, none of them provided relevant information on the quality of some of their nutrients, mostly the fatty acids, and their contribution to nutrients intake in the Beninese context.…”

Omega-3 and -6 Fatty Acid Intake and Colorectal Cancer Risk in Swedish Women’s Lifestyle and Health Cohort

“…In line with previous meta-analyses and pooled analyses that did not find an inverse association between fish intake and colorectal cancer risk [17,18], a comprehensive review by the World Cancer Research Fund concluded that the association between fish and colorectal cancer is "limited-suggestive" [3]. In a recent study from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts, the total intakes of fish, fatty fish and lean fish were associated with a reduced risk for colorectal cancer [19].…”

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

“…For example, the role that omega-3 fats in fish oil play in tumor suppression continues to be investigated, and more interventions are needed on omega-3 dosage and subtypes (DHA versus EPA) [47]. Further, European and Asian cohorts have recorded possible risk reduction of colorectal and breast cancers with omega-3 fish consumption [48,49], but more research is needed in Blacks. Brasky et al found no significant association between omega-3 and fish consumption and endometrial cancer risk in 47,602 African American women, although non-significant hazard ratios were more favorable among normal weight women (HR = 0.53; 95% CI = 0.18, 1.58) than in overweight women (HR = 0.88; 95% CI = 0.56, 1.31) [50].…”