Original articleAlimentary tractConsumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort
Section snippets
Study Participants
EPIC is a prospective cohort of 521,324 participants, recruited between 1992 and 2000 in 23 centers located in 10 European countries (Denmark, France, Germany, Greece, Italy, Netherlands, Norway, Spain, Sweden, and United Kingdom).19 Anthropometric measures, lifestyle, and dietary intake were collected at recruitment. Blood samples were also collected and stored at the International Agency for Research on Cancer (IARC) or in local biobanks. Ethical approval was obtained from the review boards
Results
After a median follow-up time of 14.9 years, 6291 incident cases of CRC (2719 men and 3572 women) were diagnosed. Of these cases, 4197 were colon cancers, whereas 2094 cases were rectal cancer cases. Compared with non-cases, cases were more likely to be current or former smokers and higher consumers of red and processed meats and alcohol (Table 1).
Discussion
In this prospective analysis of approximately half a million participants, we found that intakes of total fish including fatty fish, lean fish, and shellfish were inversely associated with CRC risk. Overall, weekly intake of 100–200 g of fatty or lean fish was associated with 7% lower CRC risk. Similarly, dietary intakes of all n-3 LC-PUFAs were inversely associated with the risk for CRC, whereas the n-6:n-3 LC-PUFA ratio was positively associated with CRC. On the other hand, circulating levels
Acknowledgments
The authors thank the EPIC study participants and staff for their valuable contribution to this research. The authors would also like to thank Mr Bertrand Hemon and Ms Carine Biessy for their support in preparing the databases and providing technical support pertaining to the data analysis.
References (26)
- et al.
Marine phosphatidylcholine suppresses 1,2-dimethylhydrazine-induced colon carcinogenesis in rats by inducing apoptosis
Nutrition Research (New York, NY)
(2008) - et al.
Nutrients, foods, and colorectal cancer prevention
Gastroenterology
(2015) - et al.
Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
CA Cancer J Clin
(2018) Cancer prevention and survival: summary of global evidence on diet, weight, physical activity and what increases or decreases your risk of cancer, London 2017
CUP Expert Report 2018: diet, nutrition, physical activity and colorectal cancer
(2018)- et al.
Growth inhibitory effect of polyunsaturated fatty acids (PUFAs) on colon cancer cells via their growth inhibitory metabolites and fatty acid composition changes
PloS One
(2015) - et al.
Dietary intake of n-3 fatty acids and colorectal cancer risk: a meta-analysis of data from 489 000 individuals
Br J Nutr
(2012) - et al.
N-3 polyunsaturated fatty acids intake and risk of colorectal cancer: meta-analysis of prospective studies
Cancer Causes Control
(2015) - et al.
Dietary intake of fish, omega-3 and omega-6 fatty acids and risk of colorectal cancer: a prospective study in U.S. men and women
Int J Cancer
(2014) - et al.
Marine omega-3 polyunsaturated fatty acids and risk of colorectal cancer according to microsatellite instability
J Natl Cancer Inst
(2015)
A 22-year prospective study of fish, n-3 fatty acid intake, and colorectal cancer risk in men
Cancer Epidemiol Biomarkers Prev
Marine n-3 and saturated fatty acids in relation to risk of colorectal cancer in Singapore Chinese: a prospective study
Int J Cancer
Marine omega-3 polyunsaturated fatty acid intake and risk of colorectal cancer characterized by tumor-infiltrating T cells
JAMA Oncol
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by a grant from the World Cancer Research Fund (WCRF) to Marc Gunter (grant number: WCRF 2013/1002). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), and Federal Ministry of Education and Research (BMBF) (Germany); Hellenic Health Foundation, Stavros Niarchos Foundation, and the Hellenic Ministry of Health and Social Solidarity (Greece); Italian Association for Research on Cancer (AIRC), National Research Council, and Associazione Iblea per la Ricerca Epidemiologica (AIRE-ONLUS) Ragusa, Associazione Volontari Italiani Sangu (AVIS) Ragusa, Sicilian Government (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), and Statistics Netherlands (the Netherlands); Nordic Center of Excellence Programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (No. 6236) and Navarra, and the Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública and Instituto de Salud Carlos II (ISCIII RETIC) (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council, and Regional Government of Skåne and Västerbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (UK), Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom).