Fish consumption and n-3 polyunsaturated fatty acids, and risk of hepatocellular carcinoma: systematic review and meta-analysis



To investigate the association between fish consumption and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of hepatocellular carcinoma (HCC).


We identified eligible studies in MEDLINE and EMBASE up to July 2014 and the reference lists of original studies and review articles on this topic. Summary relative risks (SRR) with their 95 % confidence intervals (CI) were calculated with a random effects model.


Eleven studies (three cohort studies, seven retrospective case–control studies, and one nested case–control study) met eligibility criteria. Ten articles investigated fish consumption, two articles investigated n-3 PUFA, and two articles investigated alpha-linolenic acid (ALA). The current data suggest that fish consumption was associated with 35 % reduction in HCC risk (highest vs. lowest category SRRs = 0.65, 95 % CI 0.51–0.79; test for heterogeneity p = 0.057, I 2 = 44.1 %). n-3 PUFA was associated with 51 % reduction in HCC risk (highest vs. lowest category SRRs = 0.49, 95 % CI 0.19–0.79). However, no significant inverse association was found in ALA (SRRs = 0.70, 95 % CI 0.30–1.10).


Our meta-analysis of observational studies provides evidence that fish consumption and n-3 PUFA has inverse association with the risk of HCC.

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Hepatocellular carcinoma


Body mass index


Diabetes mellitus


Polyunsaturated fatty acids


Alpha-linolenic acid


Eicosapentaenoic acid


Docosapentaenoic acid


Docosahexaenoic acid


Hepatitis B virus


Hepatitis C virus


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The authors’ responsibilities were as follows—LS and LN: contributed to the study design and writing of the manuscript; GM and SK: contributed to the data search and data collection; GMJ, GH, and LK: contributed to the data extraction and quality assessment; and YCC: contributed to the data analysis.

Conflict of interest

This work was supported by a grant from the International S&T Cooperation Program of China (No. 2013DFA11150) and the Plan Project of Science & Technology from Jining city (2014JNNK21&2014JNYYF03). The authors have declared that no competing interests exist.

Author information

Correspondence to Ning Liu.

Additional information

Min Gao and Kai Sun have contributed equally to this study.

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Gao, M., Sun, K., Guo, M. et al. Fish consumption and n-3 polyunsaturated fatty acids, and risk of hepatocellular carcinoma: systematic review and meta-analysis. Cancer Causes Control 26, 367–376 (2015).

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  • Hepatocellular carcinoma
  • Fish consumption
  • Systematic review
  • Meta-analysis
  • Relative risks