TY - JOUR
T1 - Consumption of Fish and ω-3 Fatty Acids and Cancer Risk
T2 - An Umbrella Review of Meta-Analyses of Observational Studies
AU - Lee, Keum Hwa
AU - Seong, Hyo Jin
AU - Kim, Gaeun
AU - Jeong, Gwang Hun
AU - Kim, Jong Yeob
AU - Park, Hyunbong
AU - Jung, Eunyoung
AU - Kronbichler, Andreas
AU - Eisenhut, Michael
AU - Stubbs, Brendon
AU - Solmi, Marco
AU - Koyanagi, Ai
AU - Hong, Sung Hwi
AU - Dragioti, Elena
AU - De Rezende, Leandro Fórnias Machado
AU - Jacob, Louis
AU - Keum, Nana
AU - Van Der Vliet, Hans J.
AU - Cho, Eunyoung
AU - Veronese, Nicola
AU - Grosso, Giuseppe
AU - Ogino, Shuji
AU - Song, Mingyang
AU - Radua, Joaquim
AU - Jung, Sun Jae
AU - Thompson, Trevor
AU - Jackson, Sarah E.
AU - Smith, Lee
AU - Yang, Lin
AU - Oh, Hans
AU - Choi, Eun Kyoung
AU - Shin, Jae Il
AU - Giovannucci, Edward L.
AU - Gamerith, Gabriele
N1 - Publisher Copyright:
Copyright © 2020 The Author(s) on behalf of the American Society for Nutrition.
PY - 2020/9/15
Y1 - 2020/9/15
N2 - 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.
AB - 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.
KW - cancer
KW - fish
KW - meta-analysis
KW - umbrella review
KW - ω-3 fatty acid
UR - http://www.scopus.com/inward/record.url?scp=85091125525&partnerID=8YFLogxK
U2 - 10.1093/advances/nmaa055
DO - 10.1093/advances/nmaa055
M3 - Review article
C2 - 32488249
AN - SCOPUS:85091125525
SN - 2161-8313
VL - 11
SP - 1134
EP - 1149
JO - Advances in Nutrition
JF - Advances in Nutrition
IS - 5
ER -