title: Fish consumption doesn't reduce the risk of hepatocellular carcinoma.
abstract: BACKGROUND
  Several observational studies have investigated the association between fish consumption and the risk of hepatocellular carcinoma (HCC), however, the results were inconsistent. Hence, we performed a meta-analysis of observational studies to evaluate the effect of fish consumption on HCC risk.
  
  
  METHODS
  A systematic search was performed using the Pubmed, Embase, and Cochrane Library Central database for case-control and coshort studies that assessed fish intake and HCC risk. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Subgroup analyses and sensitivity analysis were also performed.
  
  
  RESULTS
  Nine case-control studies and three cohort studies were included, involving a total of 1,071,458 participants and 2,627 HCC cases. Meta-analysis showed that there was no association between fish consumption and a significant reduction in HCC incidence (RR = 0.85, 95% CI [0.62, 1.17]). In our subgroup analyses, the result was substantially affected by adjustment for hepatic viruses' infection status. Sensitivity analysis confirmed the stability of results. Furthermore, there was no evidence of publication bias as suggested by Begg's P value (P = 0.411) and Egger's (P = 0.596) test.
  
  
  CONCLUSIONS
  In conclusion, our results do not support a significant inverse association of fish consumption with HCC risk. More in-depth studies are warranted to report more detailed results, including stratified results by fish types, preparation methods, and gender.
authors.affiliation: Department of Infectious Disease, Linyi People's Hospital Linyi 276000, China.
authors.forename: Cheng-Bao
authors.initials: CB
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Linyi People's Hospital Linyi 276000, China.
authors.forename: Qing-Xia
authors.initials: QX
authors.lastname: Fu
authors.affiliation: Department of Nursing, Linyi People's Hospital Linyi 276000, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Liu
authors.affiliation: Department of Nursing, Linyi People's Hospital Linyi 276000, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
keywords: Fish; dietary; epidemiology; hepatocellular carcinoma; meta-analysis