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Sophie Hellstrand

Sophie Hellstrand

Doctoral student

Sophie Hellstrand

Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort


  • Elom K. Aglago
  • Inge Huybrechts
  • Neil Murphy
  • Corinne Casagrande
  • Genevieve Nicolas
  • Tobias Pischon
  • Veronika Fedirko
  • Gianluca Severi
  • Marie Christine Boutron-Ruault
  • Agnès Fournier
  • Verena Katzke
  • Tilman Kühn
  • Anja Olsen
  • Anne Tjønneland
  • Christina C. Dahm
  • Kim Overvad
  • Cristina Lasheras
  • Antonio Agudo
  • Maria Jose Sánchez
  • Pilar Amiano
  • José Maria Huerta
  • Eva Ardanaz
  • Aurora Perez-Cornago
  • Antonia Trichopoulou
  • Anna Karakatsani
  • Georgia Martimianaki
  • Domenico Palli
  • Valeria Pala
  • Rosario Tumino
  • Alessio Naccarati
  • Salvatore Panico
  • Bas Bueno-de-Mesquita
  • Anne May
  • Jeroen W.G. Derksen
  • Sophie Hellstrand
  • Bodil Ohlsson
  • Maria Wennberg
  • Bethany Van Guelpen
  • Guri Skeie
  • Magritt Brustad
  • Elisabete Weiderpass
  • Amanda J. Cross
  • Heather Ward
  • Elio Riboli
  • Teresa Norat
  • Veronique Chajes
  • Marc J. Gunter

Summary, in English

Background & Aims: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs. Results: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80–0.96; Ptrend = .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82–0.98; Ptrend = .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83–1.00; Ptrend = .016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78–0.95; Ptrend = .010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18–1.45; Ptrend < .001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (Pheterogeneity = .026). Conclusions: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.


  • Diabetes - Cardiovascular Disease
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • Internal Medicine - Epidemiology

Publishing year







Clinical Gastroenterology and Hepatology





Document type

Journal article




  • Nutrition and Dietetics
  • Cancer and Oncology


  • Epidemiologic
  • Omega 3
  • Seafood
  • Tumorigenesis



Research group

  • Diabetes - Cardiovascular Disease
  • Internal Medicine - Epidemiology


  • ISSN: 1542-3565