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

被引：88

作者：

Aglago, Elom K. ^{[1
]}

Huybrechts, Inge ^{[1
]}

Murphy, Neil ^{[1
]}

Casagrande, Corinne ^{[1
]}

Nicolas, Genevieve ^{[1
]}

Pischon, Tobias ^{[2
]}

Fedirko, Veronika ^{[3
]}

Severi, Gianluca ^{[4
,5
]}

Boutron-Ruault, Marie-Christine ^{[4
,5
]}

Fournier, Agnes ^{[4
,5
]}

Katzke, Verena ^{[6
]}

Kuehn, Tilman ^{[6
]}

Olsen, Anja ^{[7
]}

Tjonneland, Anne ^{[7
,8
]}

Dahm, Christina C. ^{[9
]}

Overvad, Kim ^{[9
,10
]}

Lasheras, Cristina ^{[11
]}

Agudo, Antonio ^{[12
]}

Sanchez, Maria-Jose ^{[13
,14
]}

Amiano, Pilar ^{[15
]}

Maria Huerta, Jose ^{[14
,16
]}

Ardanaz, Eva ^{[14
,17
,18
]}

Perez-Cornago, Aurora ^{[19
]}

Trichopoulou, Antonia ^{[20
,21
]}

Karakatsani, Anna ^{[1
,10
,22
]}

Martimianaki, Georgia ^{[20
]}

Palli, Domenico ^{[23
]}

Pala, Valeria ^{[24
]}

Tumino, Rosario ^{[25
]}

Naccarati, Alessio ^{[26
]}

Panico, Salvatore ^{[27
]}

Bueno-de-Mesquita, Bas ^{[28
,29
,30
,31
]}

May, Anne ^{[32
]}

Derksen, Jeroen W. G. ^{[32
]}

Hellstrand, Sophie ^{[33
]}

Ohlsson, Bodil ^{[34
]}

Wennberg, Maria ^{[35
]}

Van Guelpen, Bethany ^{[36
]}

Skeie, Guri ^{[37
]}

Brustad, Magritt ^{[37
]}

Weiderpass, Elisabete ^{[38
]}

Cross, Amanda J. ^{[39
]}

Ward, Heather ^{[39
]}

Riboli, Elio ^{[39
]}

Norat, Teresa ^{[39
]}

Chajes, Veronique ^{[1
]}

Gunter, Marc J. ^{[1
]}

机构：

[1] Int Agcy Res Canc, Nutr & Metab Sect, Lyon, France

[2] Helmholtz Assoc, Max Delbrueck Ctr Mol Med, Mol Epidemiol Res Grp, Berlin, Germany

[3] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA

[4] Univ Paris Saclay, Univ Paris Sud, Ctr Rech Epidemiol & Sante Populat, INSERM,UVSQ, Villejuif, France

[5] Inst Gustave Roussy, Villejuif, France

[6] German Canc Res Ctr, Fdn Publ Law, Heidelberg, Germany

[7] Danish Canc Soc, Res Ctr, Diet Genes & Environm, Copenhagen, Denmark

[8] Univ Copenhagen, Fac Hlth & Med Sci, Dept Publ Hlth, Copenhagen, Denmark

[9] Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark

[10] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[11] Univ Oviedo, Sch Med, Funct Biol Dept, Asturias, Spain

[12] Catalan Inst Oncol IDIBELL, Canc Epidemiol Res Program, Unit Nutr & Canc, Barcelona, Spain

[13] Univ Granada, Inst Invest Biosanitaria ibs, Escuela Andaluza Salud Publ, Granada, Spain

[14] CIBERESP, Madrid, Spain

[15] BioDonostia Res Inst, Publ Hlth Div Gipuzkoa, San Sebastian, Spain

[16] IMIB Arrixaca, Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain

[17] Navarra Publ Hlth Inst, Pamplona, Spain

[18] Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain

[19] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

[20] Hellen Hlth Fdn, Athens, Greece

[21] Natl & Kapodistrian Univ Athens, Sch Med, Athens, Greece

[22] Natl & Kapodistrian Univ Athens, ATTIKON Univ Hosp, Sch Med, Pulm Med Dept 2, Haidari, Greece

[23] Inst Canc Res Prevent & Clin Network ISPRO, Canc Risk Factors & Life Style Epidemiol Unit, Florence, Italy

[24] Ist Nazl Tumori Milano, Fdn IRCCS, Epidemiol & Prevent Unit, Milan, Italy

[25] MP Arezzo Hosp, Canc Registry & Histopathol Dept, Ragusa, Italy

[26] IIGM, Mol Epidemiol & Expos Unit, Turin, Italy

[27] Univ Naples Federico II, Dipartimento Med Clin & Chirurg, Naples, Italy

[28] Natl Inst Publ Hlth & Environm RIVM, Dept Determinants Chron Dis DCD, Bilthoven, Netherlands

[29] Univ Med Ctr, Dept Gastroenterol & Hepatol, Utrecht, Netherlands

[30] Imperial Coll London, Dept Epidemiol & Biostat, Sch Publ Hlth, St Marys Campus, London, England

[31] Univ Malaya, Fac Med, Dept Social & Prevent Med, Kuala Lumpur, Malaysia

[32] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[33] Lund Univ, Dept Clin Sci, Malmo Diabet & Cardiovasc Dis Genet Epidemiol, Malmo, Sweden

[34] Lund Univ, Skane Univ Hosp, Dept Internal Med, Malmo, Sweden

[35] Umea Univ, Sect Sustainable Hlth, Dept Publ Hlth & Clin Med, Umea, Sweden

[36] Umea Univ, Oncol, Dept Radiat Sci, Umea, Sweden

[37] Univ Tromso, Arctic Univ Norway, Dept Community Med, Tromso, Norway

[38] Int Agcy Res Canc, Off Director, Lyon, France

[39] Imperial Coll, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2020年 / 18卷 / 03期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Epidemiologic; Seafood; Omega; 3; Tumorigenesis; DIETARY-INTAKE; METAANALYSIS; OMEGA-3;

D O I：

10.1016/j.cgh.2019.06.031

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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; 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.

引用

页码：654 / +

页数：19

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