title: Fish intake and risk of liver cancer: a meta-analysis.
abstract: BACKGROUND
  Increasing laboratory findings indicate that n-3 fatty acids, mainly derived from fish, inhibit cancer development and progression, but results from epidemiologic studies have been inconsistent and inconclusive.
  
  
  OBJECTIVE
  To evaluate the association of fish intake with risk of liver cancer by conducting a meta-analysis.
  
  
  METHODS
  Published case-control/cohort studies that evaluated the relationship between total fish intake and risk of liver cancer were found on PubMed and EMBASE. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were obtained with the random-effects model.
  
  
  RESULTS
  Five retrospective case-control studies and 5 prospective cohort studies were included in the final analysis, involving a total of 3 624 liver cancer cases. Comparing the highest with the lowest category of total fish intake, the pooled RRs of liver cancer were 0.79 (95% CI, 0.59-1.06) for case-control studies, 0.82 (95% CI, 0.70-0.96) for cohort studies and 0.82 (95% CI, 0.71-0.94) for all studies combined. The protective effects of total fish intake against liver cancer were confirmed by stratified and sensitivity analyses. In addition, an increase in fish intake of 1 serving/week was estimated to be significantly associated with 6% lower risk of liver cancer (RR = 0.94, 95% CI, 0.91-0.98).
  
  
  CONCLUSIONS
  Findings from this meta-analysis suggest that a higher fish intake is associated with reduced risk of liver cancer.
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Rui-Xue
authors.initials: RX
authors.lastname: Huang
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Yan-Ying
authors.initials: YY
authors.lastname: Duan
authors.affiliation: Department of Occupational and Environmental Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Jian-An
authors.initials: JA
authors.lastname: Hu
mesh_terms: D016022:Case-Control Studies; D004435:Eating; D005396:Fish Products / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*