Fish Consumption and Colorectal Cancer Risk in Humans: A Systematic Review and Meta-analysis
American Journal of Medicine, 05/30/2012
Evidence Based Medicine
Wu S et al. – The findings from this meta–analysis suggest that fish consumption is inversely associated with colorectal cancer.Methods
- Relevant studies were identified by a search of MEDLINE and EMBASE databases to May 2011, with no restrictions.
- Reference lists from retrieved articles also were reviewed.
- Studies that reported odds ratio (OR) or relative risk estimates with 95% confidence intervals (CIs) for the association between the consumption of fish and the risk of colorectal, colon, or rectal cancer were included.
- Two authors independently extracted data and assessed study quality.
- The risk estimate (hazard ratio, relative risk, or OR) of the highest and lowest reported categories of fish intake were extracted from each study and analyzed using a random–effects model.
- Twenty–two prospective cohort and 19 case–control studies on fish consumption and colorectal cancer risk met the inclusion criteria and were included in the meta–analysis.
- The analysis found that fish consumption decreased the risk of colorectal cancer by 12% (summary OR, 0.88; 95% CI, 0.80–0.95).
- The pooled ORs of colorectal cancer for the highest versus lowest fish consumption in case–control studies and cohort studies were 0.83 (95% CI, 0.72–0.95) and 0.93 (95% CI, 0.86–1.01), respectively.
- There was heterogeneity among case–control studies (P<.001) but not among cohort studies.
- A significant inverse association was found between fish intake and rectal cancer (summary OR, 0.79; 95% CI, 0.65–0.97), and there was a modest trend seen between fish consumption and colon cancer (summary OR, 0.96; 95% CI, 0.81–1.14).
- This study had no publication bias.