Consumption of n-3 Fatty Acids and Fish Reduces Risk of HCC
Consumption of n-3 Fatty Acids and Fish Reduces Risk of HCC
Background & Aims Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). Although consumption of fish and n-3 PUFA has been reported to protect against the development of some types of cancer, little is known about its association with hepatocellular carcinoma (HCC).
Methods We investigated the association between fish and n-3 PUFA consumption and HCC incidence (n = 398) in a population-based prospective cohort study of 90,296 Japanese subjects (aged, 45–74 y). Hazard ratios and 95% confidence intervals (CIs) for the highest vs the lowest quintile were estimated from multivariable adjusted Cox proportional hazards regression models. We also conducted subanalyses of subjects with known hepatitis B virus (HBV) or hepatitis C virus (HCV) status, and of subjects who were anti-HCV and/or hepatitis B surface antigen positive. All tests of statistical significance were 2-sided.
Results Among all subjects, consumption of n-3 PUFA-rich fish and individual n-3 PUFAs was associated inversely with HCC, in a dose-dependent manner. Hazard ratios for the highest vs lowest quintiles were 0.64 (95% CI, 0.42–0.96) for n-3 PUFA-rich fish, 0.56 (95% CI, 0.36–0.85) for EPA, 0.64 (95% CI, 0.41–0.98) for DPA, and 0.56 (95% CI, 0.35–0.87) for DHA. These inverse associations were similar irrespective of HCV or HBV status.
Conclusions Consumption of n-3 PUFA-rich fish or n-3 PUFAs, particularly EPA, DPA, and DHA, appears to protect against the development of HCC, even among subjects with HBV and/or HCV infection.
The most important risk factor in the development of hepatocellular carcinoma (HCC) in human beings is chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV). The markedly poor prognosis of HCC, with a 5-year survival rate in Japan of less than 20%, emphasizes the need for effective preventive measures, particularly in hepatitis virus carriers. Although dietary factors also might be risk factors, the role of diet in the etiology of HCC remains unclear, except with regard to alcohol consumption and aflatoxin contamination.
A recent prospective study showed an inverse association between white meat, including fish, and liver cancer. Inverse associations with the consumption of white meat or fish were observed in some studies, but were not confirmed in others. Moreover, except for 2 case-control studies, most previous epidemiologic studies of white meat or fish and HCC did not consider HCV or HBV infection status.
Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), and several studies have documented a protective effect of dietary n-3 PUFA on the development of several cancers. However, less is known about the influence of n-3 PUFA on HCC.
Here, we investigated the presence of an association between fish and n-3 PUFA consumption and HCC in a large-scale, population-based, cohort study in Japan, with consideration for HCV and HBV infection status.
Abstract and Introduction
Abstract
Background & Aims Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). Although consumption of fish and n-3 PUFA has been reported to protect against the development of some types of cancer, little is known about its association with hepatocellular carcinoma (HCC).
Methods We investigated the association between fish and n-3 PUFA consumption and HCC incidence (n = 398) in a population-based prospective cohort study of 90,296 Japanese subjects (aged, 45–74 y). Hazard ratios and 95% confidence intervals (CIs) for the highest vs the lowest quintile were estimated from multivariable adjusted Cox proportional hazards regression models. We also conducted subanalyses of subjects with known hepatitis B virus (HBV) or hepatitis C virus (HCV) status, and of subjects who were anti-HCV and/or hepatitis B surface antigen positive. All tests of statistical significance were 2-sided.
Results Among all subjects, consumption of n-3 PUFA-rich fish and individual n-3 PUFAs was associated inversely with HCC, in a dose-dependent manner. Hazard ratios for the highest vs lowest quintiles were 0.64 (95% CI, 0.42–0.96) for n-3 PUFA-rich fish, 0.56 (95% CI, 0.36–0.85) for EPA, 0.64 (95% CI, 0.41–0.98) for DPA, and 0.56 (95% CI, 0.35–0.87) for DHA. These inverse associations were similar irrespective of HCV or HBV status.
Conclusions Consumption of n-3 PUFA-rich fish or n-3 PUFAs, particularly EPA, DPA, and DHA, appears to protect against the development of HCC, even among subjects with HBV and/or HCV infection.
Introduction
The most important risk factor in the development of hepatocellular carcinoma (HCC) in human beings is chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV). The markedly poor prognosis of HCC, with a 5-year survival rate in Japan of less than 20%, emphasizes the need for effective preventive measures, particularly in hepatitis virus carriers. Although dietary factors also might be risk factors, the role of diet in the etiology of HCC remains unclear, except with regard to alcohol consumption and aflatoxin contamination.
A recent prospective study showed an inverse association between white meat, including fish, and liver cancer. Inverse associations with the consumption of white meat or fish were observed in some studies, but were not confirmed in others. Moreover, except for 2 case-control studies, most previous epidemiologic studies of white meat or fish and HCC did not consider HCV or HBV infection status.
Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), and several studies have documented a protective effect of dietary n-3 PUFA on the development of several cancers. However, less is known about the influence of n-3 PUFA on HCC.
Here, we investigated the presence of an association between fish and n-3 PUFA consumption and HCC in a large-scale, population-based, cohort study in Japan, with consideration for HCV and HBV infection status.
