Table 3.
Change in marine ω-3 polyunsaturated fatty acid intake after diagnosis and colorectal cancer-specific and all-cause mortality
| Decrease of ≥0.15 g/day |
Decrease of 0.02– 0.14 g/day |
Change of <0.02 g/day |
Increase of 0.02– 0.14 g/day |
Increase of ≥0.15 g/day |
P for trend * |
|
|---|---|---|---|---|---|---|
| Median intake (interquartile range) | −0.25 (−0.41, −0.20) | −0.06 (−0.10, −0.03) | 0 (−0.01, 0.01) | 0.06 (0.04, 0.10) | 0.37 (0.20, 0.62) | |
| Person-years | 2,271 | 3,670 | 2,208 | 2,945 | 2,477 | |
| Colorectal cancer-specific mortality | ||||||
| No. of deaths (n=169) | 36 | 51 | 35 | 34 | 13 | |
| Age-adjusted HR (95% CI) † | 1.02 (0.55–1.89) | 1.02 (0.63–1.63) | 1 (referent) | 0.96 (0.57–1.61) | 0.28 (0.13–0.57) | <0.001 |
| Multivariable-adjusted HR (95% CI) ‡ | 1.10 (0.59–2.08) | 1.16 (0.71–1.91) | 1 (referent) | 1.10 (0.64–1.89) | 0.30 (0.14–0.64) | <0.001 |
| All-cause mortality | ||||||
| No. of deaths (n=561) | 108 | 161 | 88 | 127 | 77 | |
| Age-adjusted HR (95% CI) † | 1.26 (0.91–1.75) | 1.25 (0.95–1.65) | 1 (referent) | 1.24 (0.93–1.65) | 0.82 (0.59–1.13) | 0.005 |
| Multivariable-adjusted HR (95% CI) ‡ | 1.21 (0.86–1.69) | 1.23 (0.93–1.63) | 1 (referent) | 1.21 (0.90–1.62) | 0.87 (0.62–1.21) | 0.03 |
Abbreviation: CI, confidence interval; HR, hazard ratio.
P for trend was calculated using median intake for each category of marine ω-3 polyunsaturated fatty acid intake.
Cox proportional hazards regression model stratified by age groups at diagnosis (<60, 60–64, 65–69, 70–74, and ≥75 years), sex, and cancer stage (I, II, III, IV, and unspecified) with additional adjustment for age at diagnosis (continuous).
Further adjusted for pre-diagnostic intake of marine ω-3 polyunsaturated fatty acids (continuous), grade of differentiation (1–3 and unspecified), subsite (proximal colon, distal colon, rectum and unspecified), pack-years of smoking (0, 1–15, 16–25, 26–45, >45), alcohol consumption (<0.15, 0.15–1.9, 2.0–7.4, ≥7.5 g/d), BMI (<23, 23–24.9, 25–27.4, 27.5–29.9, ≥30 kg/m2), physical activity (women: <5, 5–11.4, 11.5–21.9, ≥22 MET–hours/week; men: <7, 7–14.9, 15–24.9, ≥25 MET-hours/week), regular use of aspirin and NSAIDs (yes or no), postmenopausal hormone use (women only: never, current, past users), and intake of folate and vitamin D (in quartiles).