Lung Cancer

The effects of fish consumption on lung cancer risk appear to be mixed. A meta-analysis that included 20 studies of 8799 lung cancer cases and 17,072 controls demonstrated a significant decrease in lung cancer risk with high fish consumption (RR, 0.79; 95% CI, 0.69-0.92), though this effect was largely due to the case-control studies (RR, 0.76; 95% CI, 0.63-0.91) rather than the cohort studies (RR, 0.95; 95% CI, 0.73-1.24).15 Another meta-analysis, however, found no association between fish consumption and lung cancer risk (RR, 1.01; 95% CI, 0.96-1.07).16


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Female Reproductive Cancers

Several meta-analyses found no association between fish consumption and breast cancer risk, with the most recent analysis, which included 27 studies, resulting in an SRR of 0.96 (95% CI, 0.87-1.07).17,18 A cohort study of an Icelandic population that was not included in the meta-analysis demonstrated a protective effect against breast cancer when 4 or more servings weekly were consumed during mid-life (hazard ratio [HR], 0.46; 95% CI, 0.22-0.97), but no effect when consumed during adolescence (OR, 0.71; 95% CI, 0.44-1.13), compared with 2 or fewer servings consumed weekly.19

Meta-analyses also found no association between fish consumption and overall risk of endometrial or ovarian cancers.20-24 An additional serving of fish per week, however, modestly reduced the risk of endometrial cancer among smokers (RR, 0.95; 95% CI, 0.91-1.00).20

Genitourinary Cancers

Meta-analyses found no effect for fish consumption on risk of bladder cancer, renal cell carcinoma, or prostate cancer.25-27 The meta-analysis for prostate cancer did, however, find a 63% reduction in risk of prostate cancer–specific mortality with fish consumption (RR, 0.37; 95% CI, 0.18-0.74).27 A more recent case-control study not included in the meta-analysis found a decreased risk of aggressive prostate cancer with fish consumption, but did not remain significant after adjusting for covariates.28

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Thyroid Cancer

A meta-analysis of 19 studies found that high levels of fish consumption resulted in a lower risk of thyroid cancer compared with the lowest level of consumption (OR, 0.79; 95% CI, 0.66-0.94), with no association with high consumption of salt water fish, fresh water fish, or shellfish.29 A more recent cohort study not included in the meta-analysis found no association between fish consumption overall or any specific type and the risk of differentiated thyroid cancer.30

Hematologic Cancers

Several meta-analyses demonstrated that fish consumption has a protective effect on some hematologic cancers. A meta-analysis of 33 studies, for example, demonstrated that fish and seafood consumption reduced the risk of multiple myeloma (SRR, 0.71; 95% CI, 0.51-1.00), but had no effect on the risk of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, or follicular lymphoma.31 Another meta-analysis, which included 5 case-control studies, also found a protective effect of fish consumption against the risk of multiple myeloma (RR, 0.65; 95% CI, 0.45-0.91).32

A meta-analysis of 18 studies evaluated the effect of the timing of fish consumption and the risk of leukemia.33 Fish consumed during early childhood (ages 0 to 4) significantly reduced the risk of childhood leukemia (OR, 0.27; 95% CI, 0.14-0.53), though there was no association with maternal fish consumption during pregnancy.

Conclusions

Epidemiologic evidence indicates that fish consumption is not associated with an increased risk of cancer of any type, and high consumption may have a protective benefit against gastrointestinal cancers, thyroid cancer, multiple myeloma, and childhood leukemia.

References

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