title: Fish consumption and n-3 polyunsaturated fatty acids, and risk of hepatocellular carcinoma: systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the association between fish consumption and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of hepatocellular carcinoma (HCC).
  
  
  METHODS
  We identified eligible studies in MEDLINE and EMBASE up to July 2014 and the reference lists of original studies and review articles on this topic. Summary relative risks (SRR) with their 95 % confidence intervals (CI) were calculated with a random effects model.
  
  
  RESULTS
  Eleven studies (three cohort studies, seven retrospective case-control studies, and one nested case-control study) met eligibility criteria. Ten articles investigated fish consumption, two articles investigated n-3 PUFA, and two articles investigated alpha-linolenic acid (ALA). The current data suggest that fish consumption was associated with 35 % reduction in HCC risk (highest vs. lowest category SRRs = 0.65, 95 % CI 0.51-0.79; test for heterogeneity p = 0.057, I (2) = 44.1 %). n-3 PUFA was associated with 51 % reduction in HCC risk (highest vs. lowest category SRRs = 0.49, 95 % CI 0.19-0.79). However, no significant inverse association was found in ALA (SRRs = 0.70, 95 % CI 0.30-1.10).
  
  
  CONCLUSIONS
  Our meta-analysis of observational studies provides evidence that fish consumption and n-3 PUFA has inverse association with the risk of HCC.
authors.affiliation: Department of Clinical Laboratory, Jining NO. 1 People's Hospital, 6 Jiankang Road, Jining, 272011, China.
authors.forename: Min
authors.initials: M
authors.lastname: Gao
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Mujie
authors.initials: M
authors.lastname: Guo
authors.forename: Hang
authors.initials: H
authors.lastname: Gao
authors.forename: Kun
authors.initials: K
authors.lastname: Liu
authors.forename: Cuicui
authors.initials: C
authors.lastname: Yang
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
mesh_terms: D000818:Animals; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control*; D016022:Case-Control Studies; D015331:Cohort Studies; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005396:Fish Products; D005399:Fishes; D006801:Humans; D008113:Liver Neoplasms / Q000517:prevention & control*; D008297:Male; D064887:Observational Studies as Topic; D012189:Retrospective Studies; D012306:Risk; D017962:alpha-Linolenic Acid
chemical_list: D016588:Anticarcinogenic Agents; D015525:Fatty Acids, Omega-3; D017962:alpha-Linolenic Acid