Background Studies have reported inconsistent results for the existence of an association between polyunsaturated fatty acid (PUFA) intake and risk of lung cancer. The purpose of this study is to summarize the evidence regarding this relationship using a dose response meta-analytic approach. Methodology and Principal Findings We searched the PubMed, EmBase, and Cochrane Library electronic databases for related articles published through July 2013. Only prospective studies that reported effect estimates with 95% confidence intervals (CIs) of lung cancer incidence for greater than 2 categories of PUFA intake were included. We did random-effects meta-analyses of study-specific incremental estimates to determine the risk of lung cancer associated with a 5 g per day increase in PUFA intake. Overall, we included 8 prospective cohort studies reporting data on 1,268,442 individuals. High PUFA intake had little or no effect on lung cancer risk (risk ratio [RR], 0.91; 95% CI, 0.78–1.06; P = 0.230). Furthermore, the dose-response meta-analysis also suggested that a 5 g per day increase in PUFA has no significant effect on the risk of lung cancer (RR, 0.98; 95%CI: 0.96–1.01; P = 0.142). Finally, the findings of dose response curve suggested that PUFA intake of up to 15 g/d seemed to increase the risk of lung cancer. Furthermore, PUFA intake greater than 15 g/d was associated with a small beneficial effect and borderline statistical significance. Subgroup analyses for 5 g per day increment in PUFA indicated that the protective effect of PUFA was more evident in women (RR, 0.94; 95% CI, 0.87–1.01; P = 0.095) than in men (RR, 1.00; 95% CI, 0.98–1.02; P = 0.784). Conclusion/Significance Our study indicated that PUFA intake had little or no effect on lung cancer risk. PUFA intake might play an important role in lung cancer prevention in women.
References
[1]
Jemal A, Siegel R, Ward E, Hao Y, Xu J, et al. (2009) Cancer statistics, 2009. CA Cancer J Clin 59: 225–249.
[2]
Wingo PA, Cardinez CJ, Landis SH (2003) Long-term trends in cancer mortality in the United States, 1930–1998. Cancer 97: 3133–3275.
[3]
Baronzio G, Freitas I, Griffini P, Bertone V, Pacini F, et al. (1994) Omega-3 fatty acids can improve radioresponse modifying tumor interstitial pressure, blood rheology and membrane peroxidability. Anticancer Res 14: 1145–54.
[4]
Avula CPR, Lawrence RA, Jolly CA (2000) Role of n-3 polyunsaturated fatty acids (PUFA) in autoimmunity, inflammation, carcinogenesis, and apoptosis. Recent Res Develop Lipids 4: 303–19.
[5]
Troyer D, Fernandes G (1996) Nutrition and apoptosis. Nutr Res 16: 1959–87.
[6]
De Stefani E, Deneo-Pellegrini H, Mendilaharsu M, Carzoglio JC, Ronco A (1997) Dietary fat and lung cancer: a case-control study in Uruguay. Cancer Causes Control 8: 913–21.
[7]
Goodman MT, Kolonel LN, Yoshizawa CN, Hankin JH (1988) The effect of dietary cholesterol and fat on the risk of lung cancer in Hawaii. Am J Epidemiol 128: 1241–55.
[8]
Wynder EL, Hebert JR, Kabat GC (1987) Association of dietary fat and lung cancer. J Natl Cancer Inst 79: 631–7.
[9]
Takezaki T, Inoue M, Kataoka H, Ikeda S, Yoshida M, et al. (2003) Diet and lung cancer risk from a 14-year population-based prospective study in Japan: with special reference to fish consumption. Nutr Cancer 45: 160–167.
[10]
Veierod MB, Laake P, Thelle DS (1997) Dietary fat intake and risk of lung cancer: a prospective study of 51,452 Norwegian men and women. Eur J Cancer Prev 6: 540–549.
[11]
Moher D, Liberati A, Tetzlaff J (2009) PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Plos Medicine 6: e1000097.
[12]
Wells G, Shea B, O'Connell D (2009) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa (ON): Ottawa Hospital Research Institute. Available: http://www.ohri.ca/programs/clinical_epi？demiology/oxford.htm.
[13]
Higgins JP, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. Available: www.cochrane-handbook.org.
[14]
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7: 177–88.
[15]
Ades AE, Lu G, Higgins JP (2005) The interpretation of random-effects metaanalysis in decision models. Med Decis Making 25: 646–54.
[16]
Orsini N, Bellocco R (2006) Generalized least squares for trend estimation of summarized dose-response data. Stata J 6: 40–57.
[17]
Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 135: 1301–09.
[18]
Deeks JJ, Higgins JPT, Altman DG (2008) Analyzing data and undertaking meta-analyses. In: Higgins J, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Oxford, UK: The Cochrane Collaboration: chap 9.
Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315: 629–34.
[21]
Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50: 1088–1101.
[22]
Daniel CR, Cross AJ, Graubard BI, Hollenbeck AR, Park Y, et al. (2011) Prospective Investigation of Poultry and Fish Intake in Relation to Cancer Risk. Cancer Prev Res 4: 1903–11.
[23]
Bandera EV, Freudenheim JL, Marshall JR, Zielezny M, Priore RL, et al. (1997) Diet and Alcohol Consumption and Lung Cancer Risk in the New York State Cohort (UnitedStates). Cancer Causes and Control 8: 828–840.
[24]
Knekt P, Sepp？nen R, J？rvinen R, Virtamo J, Hyv？nen L, et al. (1991) Dietary cholesterol, fatty acids, and the risk of lung cancer among men. Nutr Cancer 16: 267–275.
[25]
Ozasa K, Watanab Y, Ito Y, Suzuki K, Tamakoshi A, et al. (2001) Dietary Habits and Risk of Lung Cancer Death in a Large-scale Cohort Study (JACC Study) in Japan by Sex and Smoking Habit. Jpn J Cancer Res 92: 1259–1269.
[26]
Laake I, Carlsen MH, Pedersen JI, Weiderpass E, Selmer R, et al. (2013) Intake of trans fatty acids from partially hydrogenated vegetable and fish oils and ruminant fat in relation to cancer risk. Int J Cancer 132: 1389–1403.
[27]
Linseisen J, Rohrmann S, Bueno-de-Mesquita B, Büchner FL, Boshuizen HC, et al. (2011) Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition. Cancer Causes Control 22: 909–918.
[28]
Koo LC (1988) Dietary habits and lung cancer risk among Chinese females in Hong Kong who never smoked. Nutr Cancer 11: 155–172.
[29]
Pierce RJ, Kune GA, Kune S, Watson LF, Field B, et al. (1989) Dietary and alcohol intake, smoking pattern, occupational risk, and family history in lung cancer patients: results of a case-control study in males. Nutr Cancer 12: 237–248.
[30]
Darby S, Whitley E, Doll R, Key T, Silcocks P (2001) Diet, smoking and lung cancer: a case-control study of 1000 cases and 1500 controls in South-West England. Br J Cancer 84: 728–735.
[31]
Goodman MT, Hankin JH, Wilkens LR, Kolonel LN (1992) High-fat foods and the risk of lung cancer. Epidemiology 3: 288–299.
[32]
Sankaranarayanan R, Varghese C, Duffy SW, Padmakumary G, Day NE, et al. (1994) A case-control study of diet and lung cancer in Kerala, south India. Int J Cancer 58: 644–649.
[33]
Swanson CA, Mao BL, Li JY, Lubin JH, Yao SX, et al. (1992) Dietary determinants of lung-cancer risk: results from a case-control study in Yunnan Province, China. Int J Cancer 50: 876–880.
[34]
Wakai K, Ohno Y, Genka K, Ohmine K, Kawamura T, et al. (1999) Risk modification in lung cancer by dietary intake of preserved foods and soyfoods: findings from a case-control study in Okinawa, Japan. Lung Cancer 25: 147–159.
[35]
Porter NA, Caldwell SE, Mills KA (1995) Mechanisms of free radical oxidation of unsaturated lipids. Lipids 30: 277–290.
[36]
Takezaki T, Hirose K, Inoue M, Hamajima N, Yatabe Y, et al. (2011) Dietary factors and lung cancer risk in Japanese: with special reference to fish consumption and adenocarcinomas. Br J Cancer 84: 1199–1206.
