Table 3.
Hazard ratios (HRs) and 95% confidence intervals (CIs) of colorectal cancer, overall and by subsite, according to cumulative average intake of fish, ω-3 and ω-6 polyunsaturated fatty acids in the Health Professionals Follow-up Study1
| Colorectal cancer
|
Proximal colon cancer
|
Distal colon cancer
|
Rectal cancer
|
||||||
|---|---|---|---|---|---|---|---|---|---|
| Person-years | Cases | HR (95% CI) | Cases | HR (95% CI) | Cases | HR (95% CI) | Cases | HR (95% CI) | |
| Fish intake, g/d | |||||||||
| <16 | 252,269 | 264 | 1.00 (referent) | 90 | 1.00 (referent) | 72 | 1.00 (referent) | 68 | 1.00 (referent) |
| ≥16 to <30 | 282,051 | 273 | 0.90 (0.76-1.07) | 91 | 0.85 (0.63-1.15) | 89 | 1.20 (0.87-1.65) | 59 | 0.73 (0.51-1.04) |
| ≥30 to <46 | 196,165 | 226 | 1.09 (0.90-1.32) | 77 | 1.07 (0.78-1.48) | 74 | 1.45 (1.02-2.05) | 43 | 0.78 (0.52-1.16) |
| ≥46 | 238,383 | 224 | 0.88 (0.72-1.08) | 84 | 0.95 (0.68-1.34) | 67 | 1.12 (0.77-1.64) | 45 | 0.60 (0.39-0.93) |
| P for trend | 0.43 | 0.90 | 0.63 | 0.05 | |||||
| 18:3ω-3 (ALA), g/d | |||||||||
| <0.90 | 246,269 | 272 | 1.00 (referent) | 82 | 1.00 (referent) | 90 | 1.00 (referent) | 59 | 1.00 (referent) |
| ≥0.90 to <1.10 | 301,231 | 299 | 0.96 (0.80-1.14) | 119 | 1.20 (0.89-1.62) | 76 | 0.82 (0.59-1.13) | 70 | 0.98 (0.68-1.40) |
| ≥1.10 to <1.30 | 227,070 | 235 | 1.01 (0.83-1.23) | 88 | 1.18 (0.85-1.64) | 69 | 1.02 (0.71-1.45) | 50 | 0.89 (0.59-1.35) |
| ≥1.30 | 194,298 | 181 | 0.89 (0.70-1.13) | 53 | 0.81 (0.53-1.23) | 66 | 1.15 (0.75-1.75) | 36 | 0.68 (0.41-1.15) |
| P for trend | 0.45 | 0.35 | 0.39 | 0.14 | |||||
| Marine ω-3, g/d | |||||||||
| <0.16 | 262,869 | 240 | 1.00 (referent) | 82 | 1.00 (referent) | 65 | 1.00 (referent) | 63 | 1.00 (referent) |
| ≥0.16 to <0.27 | 242,720 | 267 | 1.18 (0.99-1.41) | 93 | 1.16 (0.86-1.57) | 85 | 1.50 (1.08-2.09) | 54 | 0.90 (0.62-1.31) |
| ≥0.27 to <0.41 | 228,420 | 258 | 1.24 (1.03-1.50) | 93 | 1.31 (0.96-1.79) | 80 | 1.50 (1.06-2.12) | 49 | 0.90 (0.61-1.33) |
| ≥0.41 | 234,859 | 222 | 1.05 (0.85-1.30) | 74 | 1.03 (0.72-1.47) | 71 | 1.43 (0.97-2.11) | 49 | 0.79 (0.51-1.22) |
| P for trend | 0.82 | 0.95 | 0.16 | 0.31 | |||||
| Total ω-6, g/d | |||||||||
| <10.0 | 281,931 | 304 | 1.00 (referent) | 102 | 1.00 (referent) | 94 | 1.00 (referent) | 64 | 1.00 (referent) |
| ≥10.0 to <12.0 | 294,336 | 278 | 0.97 (0.81-1.14) | 101 | 1.04 (0.78-1.39) | 81 | 0.93 (0.68-1.26) | 61 | 1.04 (0.72-1.50) |
| ≥12.0 to <14.0 | 221,201 | 218 | 1.05 (0.87-1.27) | 76 | 1.13 (0.82-1.56) | 70 | 1.03 (0.74-1.44) | 49 | 1.14 (0.77-1.70) |
| ≥14.0 | 171,400 | 187 | 1.17 (0.95-1.44) | 63 | 1.25 (0.88-1.79) | 56 | 0.97 (0.66-1.41) | 41 | 1.30 (0.84-2.03) |
| P for trend | 0.12 | 0.19 | 0.98 | 0.23 | |||||
1
Cox proportional hazards model was used and adjusted for age, calendar year, family history of colorectal cancer, prior lower gastrointestinal endoscopy, pack-years of smoking before age 30, body mass index, physical activity, current multivitamin use, regular aspirin or NSAID use (≥2 tablets/week), total caloric intake, red meat, process meat, alcohol consumption, and energy-adjusted intake of folate, calcium, vitamin D and total fiber.