In a large Japanese adult population (n=90,296), the consumption of n-3 fatty acids and fish was associated with reduced risk for hepatocellular cancer (HCC) (Gastroenterology 2012; 142: 1468-75 and editorial 1411-12).
HCC ranks fifth among cancer incidence and third for mortality worldwide. Many factors contributing to HCC cannot be modified. The main factors subject to modification include diet and avoidance of viral hepatitis. Dietary studies are methodologically-challenging due to difficulties assessing diet and due to the complex nature of diets. Without going into any significant detail, this study shows an inverse relationship between fish intake and incidence of HCC. The hazard ratio for the highest quintiles compared to the lowest were 0.56-0.64 depending on the specific dietary agent. The specific n-3 polyunsaturated fatty acids (PUFA) examined included eicosapentaenoic acid (EPA), docosapentaenoic adic (DPA), and docosahexaenoic acid (DHA).
HCC Established Risk Factors:
Age, males, family history of HCC, HCV/HBV infection, alcohol, cirrhosis, tobacco, aflatoxin exposure, Hereditary Hemochromatosis, α-1 antitrypsin deficiency, primary biliary cirrhosis
Likely Risk Factors:
Diabetes, obesity, NAFLD
Possible Risk Factors:
Red meat, saturated fat, fructose, oral contraceptives
Possible Protective Factors:
Coffee, micronutrients (vitamin D, vitamin E, selenium), white meat (fish, poultry), and n-3 fatty acids
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