Abstract
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.
Highlights
Every one additional serving/week of fish intake was significantly associated with inversed endometrial cancer risk in studies adjusted for smoking (RR: 0.95 (0.91–1.00)), or studies performed in Europe (RR: 0.90 (0.84–0.97)), but not in other tested subgroups
We performed a comprehensive systematic review and meta-analysis of epidemiological studies to assess the association between intake of fish/n-3 polyunsaturated fatty acids (PUFAs) and endometrial cancer risk
After summarizing all available evidence, no significant association was detected for intake of overall fish, which is consistent with findings from an earlier meta-analysis [26]
Summary
An important part of diets worldwide, has been shown to be relevant to multiple human diseases, including several types of cancer [3,4,5,6,7,8,9,10,11,12]. Research suggests that specific types of fish contain high levels of n-3 polyunsaturated fatty acids (PUFAs) (e.g., eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA)), which can potentially exert anti-inflammatory and anti-carcinogenic effects [13]. It is critical to better understand the etiology of this cancer, and identify www.impactjournals.com/oncotarget
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