title: Consumption of n-3 fatty acids and fish reduces risk of hepatocellular carcinoma.
abstract: OBJECTIVE
  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.
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tsukiji, Chuo-ku Tokyo, Japan. nsawada@ncc.go.jp
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
authors.forename: Motoki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Shizuka
authors.initials: S
authors.lastname: Sasazuki
authors.forename: Taichi
authors.initials: T
authors.lastname: Shimazu
authors.forename: Taiki
authors.initials: T
authors.lastname: Yamaji
authors.forename: Ribeka
authors.initials: R
authors.lastname: Takachi
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000368:Aged; D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control* / Q000821:virology; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005399:Fishes; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012306:Risk; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3