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Title: Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort
Author: Aglago, Elom K.
Huybrechts, Inge
Murphy, Neil
Casagrande, Corinne
Nicolas, Genevieve
Pischon, Tobias
Fedirko, Veronika
Severi, Gianluca
Boutron-Ruault, Marie-Christine
Fournier, Agnès
Katzke, Verena
Kühn, Tilman
Olsen, Anja
Tjønneland, Anne
Dahm, Christina C.
Overvad, Kim
Lasheras, Cristina
Agudo, Antonio
Sánchez, María José
Amiano, Pilar
Huerta Castaño, José María
Ardanaz, Eva
Pérez Cornago, Aurora
Trichopoulou, Antonia
Karakatsani, Anna
Martimianaki, Georgia
Palli, Domenico
Pala, Valeria
Tumino, Rosario
Naccarati, Alessio
Panico, Salvatore
Bueno de Mesquita, H. Bas
May, Anne M.
Derksen, Jeroen W. G.
Hellstrand, Sophie
Ohlsson, Bodil
Wennberg, Maria
van Guelpen, Bethany
Skeie, Guri
Brustad, Magritt
Weiderpass, Elisabete
Cross, Amanda J.
Ward, Heather
Riboli, Elio
Norat, Teresa
Chajès, Véronique
Gunter, Marc J.
Keywords: Càncer colorectal
Àcids grassos insaturats
Colorectal cancer
Unsaturated fatty acids
Issue Date: 1-Mar-2020
Publisher: Elsevier Science Inc.
Abstract: 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.
Note: Versió postprint del document publicat a:
It is part of: Clinical Gastroenterology and Hepatology, 2020, vol. 18, num. 3, p. 654-666
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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