Consumption of Fish and ω-3 Fatty Acids and Cancer Risk: An Umbrella Review of Meta-Analyses of Observational Studies-Reference-Cited by-同舟云学术

Consumption of Fish and ω-3 Fatty Acids and Cancer Risk: An Umbrella Review of Meta-Analyses of Observational Studies

Published:2020-06-03 Issue:5 Volume:11 Page:1134-1149
ISSN:2161-8313
Container-title:Advances in Nutrition
language:en
Short-container-title:

Author:

Lee Keum Hwa¹,Seong Hyo Jin²,Kim Gaeun³,Jeong Gwang Hun⁴,Kim Jong Yeob²,Park Hyunbong⁵,Jung Eunyoung⁵,Kronbichler Andreas⁶^ORCID,Eisenhut Michael⁷,Stubbs Brendon⁸⁹¹⁰,Solmi Marco¹¹^ORCID,Koyanagi Ai¹²¹³,Hong Sung Hwi²¹⁴,Dragioti Elena¹⁵,de Rezende Leandro Fórnias Machado¹⁶,Jacob Louis¹²¹⁷,Keum NaNa¹⁸¹⁹,van der Vliet Hans J²⁰,Cho Eunyoung²¹²²,Veronese Nicola²³,Grosso Giuseppe²⁴,Ogino Shuji²⁵²⁶²⁷²⁸^ORCID,Song Mingyang¹⁸²⁶²⁹³⁰,Radua Joaquim³¹³²³³³⁴,Jung Sun Jae²⁶³⁵,Thompson Trevor³⁶,Jackson Sarah E³⁷,Smith Lee³⁸,Yang Lin³⁹⁴⁰,Oh Hans⁴¹,Choi Eun Kyoung⁴²,Shin Jae Il¹^ORCID,Giovannucci Edward L¹⁸²²,Gamerith Gabriele⁴³

Affiliation:

1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea

2. Yonsei University College of Medicine, Seoul, Republic of Korea

3. Keimyung University College of Nursing, Daegu, Republic of Korea

4. College of Medicine, Gyeongsang National University, Jinju, Republic of Korea

5. Yonsei University Graduate School, Department of Nursing, Seoul, Republic of Korea

6. Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria

7. Department of Pediatrics, Luton & Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom

8. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

9. South London and Maudsley NHS Foundation Trust, London, United Kingdom

10. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom

11. Department of Neuroscience, University of Padova, Padova, Italy

12. Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain

13. ICREA, Barcelona, Spain

14. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA

15. Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden

16. Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, São Paulo, Brazil

17. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France

18. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

19. Department of Food Science and Biotechnology, Dongguk University, Goyang, Republic of Korea

20. Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, VU University, Amsterdam, The Netherlands

21. Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI, USA

22. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

23. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy

24. Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy

25. Cancer Immunology and Cancer Epidemiology Programs, Dana-Farber Harvard Cancer Center, Boston, MA, USA

26. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA

27. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

28. Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA

29. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

30. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

31. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

32. Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain

33. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

34. Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

35. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

36. Department of Psychology, University of Greenwich, London, United Kingdom

37. Department of Behavioral Science and Health, University College London, London, United Kingdom

38. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Chelmsford, United Kingdom

39. Department of Cancer Epidemiology and Cancer Prevention, Alberta Health Services, Calgary, Canada

40. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada

41. School of Social Work, University of Southern California, CA, USA

42. Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea

43. Internal Medicine V, Department of Hematology and Oncology, Medical University Innsbruck, Innsbruck, Austria

Abstract

ABSTRACT Multiple studies have suggested that ω-3 fatty acid intake may have a protective effect on cancer risk; however, its true association with cancer risk remains controversial. We performed an umbrella review of meta-analyses to summarize and evaluate the evidence for the association between ω-3 fatty acid intake and cancer outcomes. We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception to December 1, 2018. We included meta-analyses of observational studies that examined associations between intake of fish or ω-3 fatty acid and cancer risk (gastrointestinal, liver, breast, gynecologic, prostate, brain, lung, and skin) and determined the level of evidence of associations. In addition, we appraised the quality of the evidence of significant meta-analyses by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. We initially screened 598 articles, and 15 articles, including 57 meta-analyses, were eligible. Among 57 meta-analyses, 15 reported statistically significant results. We found that 12 meta-analyses showed weak evidence of an association between ω-3 fatty acid intake and risk of the following types of cancer: liver cancer (n = 4 of 6), breast cancer (n = 3 of 14), prostate cancer (n = 3 of 11), and brain tumor (n = 2 of 2). In the other 3 meta-analyses, studies of endometrial cancer and skin cancer, there were no assessable data for determining the evidence levels. No meta-analysis showed convincing, highly suggestive, or suggestive evidence of an association. In the sensitivity analysis of meta-analyses by study design, we found weak associations between ω-3 fatty acid intake and breast cancer risk in cohort studies, but no statistically significant association in case-control studies. However, the opposite results were found in case of brain tumor risk. Although ω-3 fatty acids have been studied in several meta-analyses with regard to a wide range of cancer outcomes, only weak associations were identified in some cancer types, with several limitations. Considering the nonsignificant or weak evidence level, clinicians and researchers should cautiously interpret reported associations between ω-3 fatty acid consumption and cancer risks.

Funder

National Institutes of Health

Health Education England

National Institute for Health Research

Maudsley Charity

King's College

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous),Food Science

Link

http://academic.oup.com/advances/article-pdf/11/5/1134/33901640/nmaa055.pdf