The association of fish consumption with bladder cancer risk: A meta-analysis
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
The association of fish consumption with bladder cancer risk: A meta-analysis Zhongyi Li*, Jianda Yu, Qilong Miao, Shuben Sun, Lingjun Sun, Houmen Yang and Liejun Hou
Abstract Background: The association between fish consumption and risk of bladder cancer has not been established yet. The results from epidemiological studies are inconsistent. Methods: We conducted a meta-analysis of cohort and case-control studies on the relationship between fish intake and bladder cancer. We quantified associations with bladder cancer using meta-analysis of relative risk associated to the highest versus the lowest category of fish intake using random effect models. Heterogeneity among studies was examined using Q and I2 statistics. Publication bias was assessed using the Begg’s funnel plot. Results: Five cohort and 9 case-control studies were eligible for inclusion. The combined relative risk showed that fish consumption was negatively, but not significantly, associated with a decreased risk of bladder cancer (relative risk, 0.86; 95% confidence interval, 0.61-1.12). In subgroup analyses, there was no evidence that study design, geographical region, case sample size, or exposure assessment substantially influenced the estimate of effects. Conclusion: The overall current literature on fish consumption and the risk of bladder cancer suggested no association. Because of the limited number of studies, further well-designed prospective studies are needed to explore the effect of fish on bladder cancer. Keywords: Bladder neoplasms, Diet, Fish, Meta-analysis, Prevention
1. Background Bladder cancer is the second most common urologic malignancy and the seventh most common cancer in men. It has been estimated that 386,300 patients are newly diagnosed with bladder cancer worldwide in 2008, and approximately 150,200 patients were expected to die of it [1]. Depending on its stage and grade, bladder cancer may be treated with surgery, radiation therapy, chemotherapy, or immunotherapy. Because bladder cancer has the highest lifetime treatment cost of any cancer, and direct exposure to carcinogens is implicated in bladder cancer development and many potentially protective compounds are concentrated in urine, making it an ideal target for preventive therapies [2]. Smoking, occupational exposure, and chronic infections with schistosoma are the most established risk factors for bladder cancer. At present, evidence on dietary factors is also accumulating. Fish plays an important role
in the usual diet worldwide and is an ideal source of n-3 polyunsaturated fatty acids, which may lower cancer risk by suppressing mutations, inhibiting cellular proliferation, and inducing cell apoptosis [3-5]. A report by the World Cancer Research Fund and the American Institute for Cancer Research on the relationship between diet and cancer concluded, based on a comprehensive review of epidemiologic studies, that fish consumption may possibly protect against cancers of the colon, rectum, and ovary [6]. Less
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