Meta-Analysis
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2014; 20(41): 15398-15412
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15398
Fish consumption and risk of gastrointestinal cancers: A meta-analysis of cohort studies
Xiao-Feng Yu, Jian Zou, Jie Dong
Xiao-Feng Yu, Jian Zou, Jie Dong, Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai 200040, China
Author contributions: Yu XF and Zou J conceived the study; Yu XF and Dong J acquired the data independently; Zou J and Dong J performed the data analysis and interpretation; Zou J prepared the manuscript with contributions from all the co-authors; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81101617
Correspondence to: Jian Zou, Associate Professor, Department of Gastroenterology, Huadong Hospital, Fudan University, No. 221 Yan an Xi Road, Shanghai 200040, China. apollozou@hotmail.com
Telephone: +86-21-62483180 Fax: +86-21-32140503
Received: November 6, 2013
Revised: March 16, 2014
Accepted: June 13, 2014
Published online: November 7, 2014
Processing time: 368 Days and 21.3 Hours
Abstract

AIM: To assess quantitatively the relationship between fish intake and the incidence of gastrointestinal cancers in a meta-analysis of cohort studies.

METHODS: We searched MEDLINE, Embase, Science Citation Index Expanded, and the bibliographies of retrieved articles. Prospective cohort studies were included if they reported relative risks (RRs) and corresponding 95% confidence intervals (CIs) of various cancers with respect to fish intake. When RRs were not available in the published article, they were computed from the exposure distributions. Two investigators extracted the data independently and discrepancies were resolved by discussion with a third investigator. We performed random-effect meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 20-g/d increment of fish consumption.

RESULTS: Forty-two studies, comprising 27 independent cohorts, met our inclusion criteria. The studies included 2325040 participants and 24115 incident cases of gastrointestinal cancer, with an average follow-up of 13.6 years. Compared with individuals who did not eat, or seldom ate, fish, the pooled RR of gastrointestinal cancers was 0.93 (95%CI: 0.88-0.98) for regular fish consumers, 0.94 (0.89-0.99) for low to moderate fish consumers, and 0.91 (0.84-0.97) for high fish consumers. Overall, a 20-g increase in fish consumption per day was associated with a 2% reduced risk of gastrointestinal cancers (RR = 0.98; 95%CI: 0.96-1.01). In subgroup analyses, we noted that fish consumption was associated with reduced risk of colorectal (RR = 0.93; 95%CI: 0.87-0.99; P < 0.01), esophageal (RR = 0.91; 95%CI: 0.83-0.99; P < 0.05) and hepatocellular cancers (RR = 0.71; 95%CI: 0.48-0.95; P < 0.01).

CONCLUSION: This meta-analysis suggested that fish consumption may reduce total gastrointestinal cancer incidence. Inverse relationships were also detected between fish consumption and specific types of cancers.

Keywords: Diet; Cancer prevention; Fish intake; Gastrointestinal cancer

Core tip: Epidemiological studies have revealed associations between fish consumption and cancers of the gastrointestinal tract. After meta-analysis of forty-two studies, comprising 27 independent cohorts, we found that fish consumption might reduce the total incidence of gastrointestinal cancer. A 20-g increase in fish consumption per day was associated with a 2% reduced risk of gastrointestinal cancers. In subgroup analyses, fish consumption was associated with reduced risk of colorectal, esophageal and hepatocellular cancers.