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Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort.
Am J Clin Nutr 2014; 99(3):599-608AJ

Abstract

BACKGROUND

Inflammation plays an important role in endometrial cancer etiology. Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs), derived from marine sources, are thought to be antiinflammatory; however, several studies of fish consumption suggest an increase in risk.

OBJECTIVE

This study examined whether intakes of long-chain ω-3 PUFAs, including eicosapentaenoic acid (EPA; 20:5ω-3) and docosahexaenoic acid (DHA; 22:6ω-3), from diet and supplements and intake of fish are associated with endometrial cancer risk.

DESIGN

Between 2000 and 2002, 22,494 women aged 50-76 y, living in western Washington State, were recruited to the VITamins And Lifestyle cohort study. Incident endometrial cancers (n = 263) were identified through the Surveillance, Epidemiology, and End Results cancer registry after 9 y of follow-up. Multivariable-adjusted HRs and 95% CIs for the association of intakes of individual long-chain ω-3 PUFAs and fish with endometrial cancer risk were estimated by using Cox proportional hazards.

RESULTS

Women in the highest compared with the lowest quintile of dietary EPA + DHA intake had a 79% increased risk of endometrial cancer (95% CI: 16%, 175%; P-trend = 0.026). Results were similar for EPA and DHA measured individually and for fish intake. When data were stratified by body mass index (in kg/m²; <25 or ≥ 25), increases in risk of long-chain ω-3 PUFAs were restricted to overweight and obese women, and statistically significant reductions in risk were observed for normal-weight women.

CONCLUSIONS

The overall increased risk reported here confirms the findings of several prior observational studies of fish intake, which observed similar increases in risk. Randomized trials are needed to confirm these findings.

Authors+Show Affiliations

Department of Internal Medicine, Division of Cancer Prevention and Control (TMB) and the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology (DEC), The Ohio State University College of Medicine, Columbus, OH, and the Fred Hutchinson Cancer Research Center, Cancer Prevention Program, Seattle, WA (MLN and EW).No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

24500149

Citation

Brasky, Theodore M., et al. "Associations of Long-chain Ω-3 Fatty Acids and Fish Intake With Endometrial Cancer Risk in the VITamins and Lifestyle Cohort." The American Journal of Clinical Nutrition, vol. 99, no. 3, 2014, pp. 599-608.
Brasky TM, Neuhouser ML, Cohn DE, et al. Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort. Am J Clin Nutr. 2014;99(3):599-608.
Brasky, T. M., Neuhouser, M. L., Cohn, D. E., & White, E. (2014). Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort. The American Journal of Clinical Nutrition, 99(3), pp. 599-608. doi:10.3945/ajcn.113.070524.
Brasky TM, et al. Associations of Long-chain Ω-3 Fatty Acids and Fish Intake With Endometrial Cancer Risk in the VITamins and Lifestyle Cohort. Am J Clin Nutr. 2014;99(3):599-608. PubMed PMID: 24500149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of long-chain ω-3 fatty acids and fish intake with endometrial cancer risk in the VITamins And Lifestyle cohort. AU - Brasky,Theodore M, AU - Neuhouser,Marian L, AU - Cohn,David E, AU - White,Emily, Y1 - 2014/02/05/ PY - 2014/2/7/entrez PY - 2014/2/7/pubmed PY - 2014/5/3/medline SP - 599 EP - 608 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 99 IS - 3 N2 - BACKGROUND: Inflammation plays an important role in endometrial cancer etiology. Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs), derived from marine sources, are thought to be antiinflammatory; however, several studies of fish consumption suggest an increase in risk. OBJECTIVE: This study examined whether intakes of long-chain ω-3 PUFAs, including eicosapentaenoic acid (EPA; 20:5ω-3) and docosahexaenoic acid (DHA; 22:6ω-3), from diet and supplements and intake of fish are associated with endometrial cancer risk. DESIGN: Between 2000 and 2002, 22,494 women aged 50-76 y, living in western Washington State, were recruited to the VITamins And Lifestyle cohort study. Incident endometrial cancers (n = 263) were identified through the Surveillance, Epidemiology, and End Results cancer registry after 9 y of follow-up. Multivariable-adjusted HRs and 95% CIs for the association of intakes of individual long-chain ω-3 PUFAs and fish with endometrial cancer risk were estimated by using Cox proportional hazards. RESULTS: Women in the highest compared with the lowest quintile of dietary EPA + DHA intake had a 79% increased risk of endometrial cancer (95% CI: 16%, 175%; P-trend = 0.026). Results were similar for EPA and DHA measured individually and for fish intake. When data were stratified by body mass index (in kg/m²; <25 or ≥ 25), increases in risk of long-chain ω-3 PUFAs were restricted to overweight and obese women, and statistically significant reductions in risk were observed for normal-weight women. CONCLUSIONS: The overall increased risk reported here confirms the findings of several prior observational studies of fish intake, which observed similar increases in risk. Randomized trials are needed to confirm these findings. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24500149/Associations_of_long_chain_ω_3_fatty_acids_and_fish_intake_with_endometrial_cancer_risk_in_the_VITamins_And_Lifestyle_cohort_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.070524 DB - PRIME DP - Unbound Medicine ER -