Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies

Zheng, Ju‐Sheng; Hu, Xiaojie; Zhao, Yimin; Yang, Jing; Li, Duo

doi:10.1136/bmj.f3706

Cited by 312 publications

(239 citation statements)

References 52 publications

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“…14 The European Prospective Investigation into Cancer and Nutrition (EPIC) study, one of the largest prospective cohort studies, also found no significant associations between dietary intake of fish and breast cancer risk. 8 Another systematic review reported insufficient consistent results to suggest a strong association between n 2 3 PUFA and breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Fish, n − 3 polyunsaturated fatty acids and n − 6 polyunsaturated fatty acids intake and breast cancer risk: The Japan Public Health Center‐based prospective study

Kiyabu

Inoue

Saito

et al. 2015

Intl Journal of Cancer

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Limited and inconsistent studies exist on the association between the intake of fish, n − 3 polyunsaturated fatty acids (PUFA) and n − 6 PUFA and breast cancer. Fish and n − 3 PUFA support various body functions and are thought to reduce the carcinogenesis risk while n − 6 PUFA may have a positive association with cancer risk. We examined the association between intake of fish, n − 3 PUFA [including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and alpha‐linolenic acid (ALA)] and n − 6 PUFA and breast cancer with subanalyses on estrogen (ER) and progesterone receptor (PR) status. We investigated 38,234 Japanese women aged 45–74 years from the Japan Public Health Center‐based prospective study (JPHC study), and during 14.1 years of follow‐up time, 556 breast cancer cases were newly diagnosed. Breast cancer risk was not associated with the intake of total fish, n − 3 PUFA and n − 6 PUFA when analyzed in totality through multivariable Cox proportional hazards regression models with age as the time scale. Intake of total n − 6 was positively associated with the development of ER+PR+ tumors [multivariable‐adjusted HR Q4 vs. Q1 = 2.94 (95% CI: 1.26–6.89; ptrend = 0.02)]. Intake of EPA was associated with a decreased breast cancer risk for ER+PR+ tumors [multivariable‐adjusted HR Q2 vs. Q1 = 0.47 (95% CI: 0.25–0.89; ptrend =0.47)]. While the overall association between the intake of total fish, n − 3 PUFA and n − 6 PUFA and breast cancer risk is null, for ER+PR+ tumors, a positive association was seen between n − 6 intake and breast cancer, and a marginally significant inverse association was observed for EPA intake.

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Section: Discussionmentioning

confidence: 99%

Fish, n − 3 polyunsaturated fatty acids and n − 6 polyunsaturated fatty acids intake and breast cancer risk: The Japan Public Health Center‐based prospective study

Kiyabu

Inoue

Saito

et al. 2015

Intl Journal of Cancer

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“…Its role in breast cancer is unclear. In a recent meta-analysis, higher consumption of dietary marine n-3 fatty acids was associated with a lower risk of breast cancer (21). The ORIGIN trial provides evidence that n-3 fatty acids are neither beneficial nor detrimental to the development and progression of cancers in general.…”

Section: Conclusion Perspectives and Clinical Implicationsmentioning

confidence: 99%

The Association of Basal Insulin Glargine and/or n-3 Fatty Acids With Incident Cancers in Patients With Dysglycemia

Bordeleau

Yakubovich

Dagenais³

et al. 2014

Diabetes Care

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OBJECTIVEEpidemiologic studies linking insulin glargine and glucose-lowering therapies to cancers and n-3 fatty acids to cancer prevention have not been confirmed. We aimed to assess the effect of insulin glargine and n-3 fatty acids on incident cancers within the context of the ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial. RESEARCH DESIGN AND METHODSThe ORIGIN trial is an international, long-term, randomized two-by-two factorial study comparing insulin glargine with standard care and n-3 fatty acids with placebo (double blind) in people with dysglycemia at high risk for cardiovascular events. The primary outcome measure (cancer substudy) was the occurrence of any new or recurrent adjudicated cancer. Cancer mortality and cancer subtypes were also analyzed. RESULTSAmong 12,537 people (mean age 63.5 years, SD 7.8; 4,388 females), 953 developed a cancer event during the median follow-up of 6.2 years. In the glargine and standard care groups, the incidence of cancers was 1.32 and 1.32 per 100 person-years, respectively (P = 0.97), and in the n-3 fatty acid and placebo groups, it was 1.28 and 1.36 per 100 person-years, respectively (P = 0.39). No difference in the effect of either intervention was noted within predefined subgroups (P for all interactions ‡0.17). Cancer-related mortality and cancer-specific outcomes also did not differ between groups. Postrandomization HbA 1c levels, glucose-lowering therapies (including metformin), and BMI did not affect cancer outcomes. CONCLUSIONSInsulin glargine and n-3 fatty acids have a neutral association with overall and cancer-specific outcomes, including cancer-specific mortality. Exposure to glucoselowering therapies, including metformin, and HbA 1c level during the study did not alter cancer risk.Both type 2 diabetes mellitus (hereafter referred to as diabetes) and cancer are common diseases that are rising in incidence and prevalence throughout the world. Moreover, epidemiologic data suggest that diabetes is associated with an increased risk of several different cancers (1). Reasons for this association may include metabolic features typical of diabetes such as hyperglycemia, insulin resistance, and/or

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“…The effect of omega-3 and omega-6 intake on breast cancer risk in humans has not been determined. Assessing this relationship is complicated by problems assessing omega-3 and omega-6 intake from food frequency questionnaires (FFQ; 16) and inconsistent results among different populations (17,18).…”

Section: Introductionmentioning

confidence: 99%

“…Prospective studies also have generally shown an inverse association between consumption of omega-3 fatty acids from fish and/or fish oil supplements and breast cancer incidence (18). However, relatively small nested casecontrol studies within prospective cohorts, measuring fatty acid levels in the PL compartment of RBCs and serum, have largely failed to find a significant association between EPA, DHA, or total omega-3 fatty acid levels and breast cancer risk (22)(23)(24)(25)(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Omega-3 and Omega-6 Fatty Acids in Blood and Breast Tissue of High-Risk Women and Association with Atypical Cytomorphology

Hidaka

Harvey

et al. 2015

Cancer Prevention Research

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The ratio of omega-3 to omega-6 fatty acids, especially the longchain eicosapentaenoic acid (EPA) þ docosahexaenoic acid (DHA) to arachidonic acid (AA) ratio, is inversely associated with breast cancer risk. We measured the association between cytologic atypia, a biomarker for short-term risk of breast cancer development, and omega-3 and omega-6 fatty acid intake and levels in blood and breast tissue. Blood and benign breast tissue, sampled by random periareolar fine-needle aspiration (RPFNA), was obtained from 70 women at elevated risk for breast cancer. Self-reported dietary intake was assessed by the NCI's Food Frequency Questionnaire. The fatty acid composition of five lipid compartments, red blood cell, plasma and breast phospholipids, and plasma and breast triaclyglycerides (TAG), was analyzed by gas chromatography as weight percent. Median daily intakes of EPAþDHA and total omega-3 fatty acids were 80 mg and 1.1 g, respectively. The median total omega-3:6 intake ratio was 1:10. Compared with women without atypia, those with cytologic atypia had lower total omega-3 fatty acids in red blood cell and plasma phospholipids and lower omega-3:6 ratios in plasma TAGs and breast TAGs (P < 0.05). The EPAþDHA:AA ratio in plasma TAGs was also lower among women with atypia. This is the first report of associations between tissue levels of omega-3 and omega-6 fatty acids and a reversible tissue biomarker of breast cancer risk. RPFNA cytomorphology could serve as a surrogate endpoint for breast cancer prevention trials of omega-3 fatty acid supplementation. Cancer Prev Res; 8(5); 359-64. Ó2015 AACR.

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Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies

Cited by 312 publications

References 52 publications

Fish, n − 3 polyunsaturated fatty acids and n − 6 polyunsaturated fatty acids intake and breast cancer risk: The Japan Public Health Center‐based prospective study

Fish, n − 3 polyunsaturated fatty acids and n − 6 polyunsaturated fatty acids intake and breast cancer risk: The Japan Public Health Center‐based prospective study

The Association of Basal Insulin Glargine and/or n-3 Fatty Acids With Incident Cancers in Patients With Dysglycemia

Omega-3 and Omega-6 Fatty Acids in Blood and Breast Tissue of High-Risk Women and Association with Atypical Cytomorphology

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