. 2016 Jun 29;16(1):32–62. doi: 10.1177/1534735416656052

Table 6.

Nested Case-Control Studies of Fish-Derived Omega-3 Fatty Acids and Prostate Cancer Incidence.

Reference	Cohort/Study Name	Cases n	Controls n	Geographic Area	Exposure Assessment	Highest Group (Quartile, Quintile, etc)	Effect of Exposure on Outcome (Highest vs Lowest Exposure)
Assessing blood levels of fatty acids
Dahm et al (2012)⁶⁵	European Prospective Investigation into Cancer and Nutrition (EPIC) cohort	962	1061	10 European countries	Plasma FAs at baseline	Quintiles of plasma marine n-3 PUFA (not defined)	↑ risk of PrCa based on treelet transform analysis OR 1.36 (0.99, 1.86) Ptrend = .041
Crowe et al (2008)⁴⁰	European Prospective Investigation into Cancer and Nutrition (EPIC)	926	926	10 European countries	Plasma PPL FAs	EPA 1.95-9.49 mol%	↔ risk of total PrCa mvRR 1.31 (0.96-1.81) P = .09 ↑ risk of high-grade PrCa mvRR 2.00 (1.07-3.76) Ptrend = 0.031 ↔ risk of localized, advanced or low-grade PrCa
Crowe et al (2008)⁴⁰		926	926	10 European countries	Plasma PPL FAs	DHA 5.34-10.37 mol%	↔ risk of total PrCa DHA mvRR 1.39 (1.02-1.90) P = .158 ↔ risk of localized, advanced, high-grade or low-grade PrCa
Brasky et al (2011)³⁸	Prostate Cancer Prevention Trial	1658	1803	USA	Serum PPL FA at baseline	EPA >0.74%	↔ risk of low-grade or high-grade PrCa
						DHA >3.30%	↑ risk high-grade PrCa OR 2.50 (1.34, 4.65) P = .04 ↔ risk of low-grade PrCa
						EPA + DHA >4.02%	↔ risk of low-grade ↔ risk of high-grade PrCa AOR 1.99 (1.08-3.68) P = .08
Park (2009)⁸⁵	The Multiethnic Cohort Study	376	729	USA	RBC FA at baseline	EPA >0.77% DHA >8.00%	↔ risk PrCa
Chavarro et al (2008)⁴¹	Physician’s Health Study	476	476	USA	Whole blood FAs	EPA >2.36%	↓ risk of localized PrCa mvRR 0.57 (0.36-0.92) P = .02 ↔ risk of advanced, aggressive or nonaggressive PrCa
Chavarro et al (2008)⁴¹	Physician’s Health Study	476	476	USA	Whole blood FAs	DHA >3.37%	↓ risk of localized PrCa mvRR 0.60 (0.39-0.93) P = .07 ↔ risk of advanced, aggressive or nonaggressive PrCa
Harvei et al (1997)⁶⁷	N/A	141	141	Norway	Serum PPL FAs	EPA 2.00% DHA 5.67%	↔ risk of PrCa EPA OR 1.2 (0.6-1.2) P = .1; DHA OR 1.0 (0.5-1.8) P = .08
Assessing dietary intake of fatty acids
Touvier (2012)⁸⁶	SUVIMAX (Supplementation en Vitamines et Mineraux AntioXydants) Cohort Study	129	760	France	24-hour dietary records every 2 mo for first 2 years of study; baseline plasma sICAM-1	1.2 g/d n-3 fatty acid intake in women, 1.6 g/d in men	Relation between sICAM-1and PrCa modulated by n-3 PUFA intake; sICAM-1 associated with ↑ risk PrCa in patients with n-3 intakes below the median OR 6.1; (1.1-34.5) Ptrend = .03; no association in patients with intakes above median OR 0.3 (0.1-1.6) Ptrend = .2
Torfadottir et al (2013)³⁶	AGES-Reykjavik Cohort Study	343	1914	Iceland	FFQ assessing early, mid- and late-life fish intake	>4 servings total fish/wk	↔ PrCa risk with intake early- and midlife AOR 0.87 (95% CI: 0.66, 1.13), 1.05 (95% CI: 0.71, 1.57)
						Once a week or more intake of salted or smoked fish	↑ risk advanced PrCa intake early life OR 1.98 (95% CI: 1.08, 3.62); ↔ risk with intake in midlife ↔ risk of total and localized PrCa with intake in early life, midlife
						Fish oil use daily	↔ risk of total, localized, or advanced PrCa with supplementation in early life or midlife
Assessing blood levels and dietary intake of fatty acids
Gann (1994)⁸⁷	Physician’s Health Study	120	120	USA	Plasma FAs and FFQ at baseline	Quartiles of plasma FAs (not defined)	↔ risk of PrCa EPA RR 0.87 (0.41-1.82) P = .81

Abbreviations: PrCa, prostate cancer; mvRR, multivariate relative risk; mvHR, multivariate hazard ratio; AOR, adjusted odds ratio; FFQ, Food Frequency Questionnaire; ×/wk, times per week; f/u follow-up; Bl, baseline; ↓, decrease; ↑, increase; ↔, no change; FA, fatty acids; PPL, plasma phospholipids; RBC, red blood cell; n-3, omega-3; PUFA, polyunsaturated fatty acids; sICAM-1, soluble intercellular adhesion molecule-1; EPA, eicosapentaenoic acid; DHA, docosahexaenoic acid.