Dietary n-3 polyunsaturated fatty acids, fish consumption, and endometrial cancer risk: a meta-analysis of epidemiological studies
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Rui Hou1, Shen-Shen Yao1, Jia Liu1, Lian-Lian Wang1, Lang Wu2 and Luo Jiang3
1Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, P.R. China
2Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
3Department of Ultrasound, Shengjing Hospital Affiliated to China Medical University, Shenyang, P.R. China
Luo Jiang, email: [email protected]
Keywords: n-3 fatty acids, fish, epidemiology, endometrial cancer
Received: March 27, 2017 Accepted: May 21, 2017 Published: May 30, 2017
The relationship between intake of fish and n-3 fatty acids and endometrial cancer risk has not been consistent across epidemiological studies. We quantitatively assessed the aforementioned association through a systematic review and meta-analysis. PubMed and Embase were searched through March 2017 for eligible epidemiological studies. Fixed or random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs). The dose-response relationship was also evaluated. Based on the literature search, five prospective studies and 11 case-control studies were identified. All 16 studies were categorized as high-quality studies. After pooling available risk estimates, no significant association was detected between overall fish intake and endometrial cancer risk. In subgroup analyses, every one additional serving/week of fish intake was significantly associated with inversed endometrial cancer risk in studies adjusted for smoking (RR (95% CI): 0.95 (0.91–1.00)), or studies performed in Europe (RR (95% CI): 0.90 (0.84–0.97)), but not in other tested subgroups. In studies conducted in Asia, there was significant positive association (RR (95% CI): 1.15 (1.10–1.21)). Regarding n-3 PUFA intake, marginally inverse associations of high EPA or DHA intake were detected (EPA: RR (95% CI) = 0.79 (0.61–1.04); DHA: RR (95% CI) = 0.85 (0.64–1.11)). Dose-response analyses suggested a significant nonlinear relationship between DHA intake and endometrial cancer risk (p: 0.04). Overall, this meta-analysis suggests that intake of n-3 PUFA may be inversely associated with endometrial cancer risk at some level of evidence, although the exact relationship, especially for fish intake, needs further characterization. Further well-designed studies are warranted.
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