Skip to main content

Fish consumption and risk of myeloma: a meta-analysis of epidemiological studies

Abstract

Purpose

The relationship between fish consumption and multiple myeloma (MM) risk has not been consistent across epidemiological studies. We quantitatively assessed the aforementioned association through a systematic review and meta-analysis.

Methods

PubMed was searched through the end of March 2015 for eligible studies. Fixed or random effects models were used to pool risk estimates. Five case–control studies that involved 1,366 cases and 8,259 controls were identified. Three studies had high methodological quality, and two studies had low quality based on the Newcastle–Ottawa Quality Assessment Scale.

Results

After pooling all risk estimates, a significant inverse association was found between the highest category versus lowest category of fish consumption and MM risk (relative risk = 0.65, 95 % confidence interval = 0.46–0.91), with relatively high heterogeneity (I 2 = 55.6 %). No evidence of publication bias was detected. The inverse association persisted in all subgroups according to study quality, type, location, and whether there were adjustments for confounders, although statistical significance was not detected in all strata. The dose–response analysis suggested a nonlinear dose–response relationship for the association, with the lowest risk linked to fish consumption once per week.

Conclusion

This meta-analysis suggests that the highest versus lowest category of fish consumption is inversely associated with MM risk. Furthermore, a nonlinear dose–response relationship was suggested for the association. Because this evidence is based on a small number of retrospective studies with mixed quality and because high heterogeneity was detected, further prospective studies are warranted to validate our findings and better characterize the relationship.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Alexander DD, Mink PJ, Adami HO, Cole P, Mandel JS, Oken MM, Trichopoulos D (2007) Multiple myeloma: a review of the epidemiologic literature. Int J Cancer 120(Suppl 12):40–61

    Article  PubMed  Google Scholar 

  2. Becker N (2011) Epidemiology of multiple myeloma. Recent Results Cancer Res 183:25–35

    Article  PubMed  Google Scholar 

  3. Morgan GJ, Davies FE, Linet M (2002) Myeloma aetiology and epidemiology. Biomed Pharmacother 56(5):223–234

    CAS  Article  PubMed  Google Scholar 

  4. Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S (1999) Fish consumption and cancer risk. Am J Clin Nutr 70(1):85–90

    CAS  PubMed  Google Scholar 

  5. Yu XF, Zou J, Dong J (2014) Fish consumption and risk of gastrointestinal cancers: a meta-analysis of cohort studies. World J Gastroenterol 20(41):15398–15412

    PubMed Central  Article  PubMed  Google Scholar 

  6. Lu Z, Chen TC, Zhang A, Persons KS, Kohn N, Berkowitz R, Martinello S, Holick MF (2007) An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D? J Steroid Biochem Mol Biol 103(3–5):642–644

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  7. Brown LM, Gridley G, Pottern LM, Baris D, Swanso CA, Silverman DT, Hayes RB, Greenberg RS, Swanson GM, Schoenberg JB, Schwartz AG, Fraumeni JF Jr (2001) Diet and nutrition as risk factors for multiple myeloma among blacks and whites in the United States. Cancer Causes Control 12(2):117–125

    CAS  Article  PubMed  Google Scholar 

  8. Tavani A, Pregnolato A, Negri E, Franceschi S, Serraino D, Carbone A, La Vecchia C (1997) Diet and risk of lymphoid neoplasms and soft tissue sarcomas. Nutr Cancer 27(3):256–260

    CAS  Article  PubMed  Google Scholar 

  9. Hosgood HD 3rd, Baris D, Zahm SH, Zheng T, Cross AJ (2007) Diet and risk of multiple myeloma in Connecticut women. Cancer Causes Control 18(10):1065–1076

    Article  PubMed  Google Scholar 

  10. Wang Q, Wang Y, Ji Z, Chen X, Pan Y, Gao G, Gu H, Yang Y, Choi BC, Yan Y (2012) Risk factors for multiple myeloma: a hospital-based case–control study in Northwest China. Cancer Epidemiol 36(5):439–444

    Article  PubMed  Google Scholar 

  11. Fritschi L, Ambrosini GL, Kliewer EV, Johnson KC, Canadian Cancer Registries Epidemiologic Research Group (2004) Dietary fish intake and risk of leukaemia, multiple myeloma, and non-Hodgkin lymphoma. Cancer Epidemiol Biomark Prev 13(4):532–537

    CAS  Google Scholar 

  12. Guan HB, Wu L, Wu QJ, Zhu J, Gong T (2014) Parity and pancreatic cancer risk: a dose–response meta-analysis of epidemiologic studies. PLoS ONE 9(3):e92738

    PubMed Central  Article  PubMed  Google Scholar 

  13. Luan NN, Wu L, Gong TT, Wang YL, Lin B, Wu QJ (2014) Nonlinear reduction in risk for colorectal cancer by oral contraceptive use: a meta-analysis of epidemiological studies. Cancer Causes Control 26(1):65–78

    Article  PubMed  Google Scholar 

  14. GA Wells BS, D O’Connell, J Peterson, V Welch, M Losos, P Tugwell (2011) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 15 Jan 2015

  15. Wu L, Jiang Z, Li C, Shu M (2014) Prediction of heart rate variability on cardiac sudden death in heart failure patients: a systematic review. Int J Cardiol 174(3):857–860

    PubMed Central  Article  PubMed  Google Scholar 

  16. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560

    PubMed Central  Article  PubMed  Google Scholar 

  17. Kuang D, Chen W, Song YZ, Yu YY, Zhang DY, Wu L, Tang J (2014) Association between the HSPA1B ± 1267A/G polymorphism and cancer risk: a meta-analysis of 14 case–control studies. Asian Pac J Cancer Prev 15(16):6855–6861

    Article  PubMed  Google Scholar 

  18. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    CAS  Article  PubMed  Google Scholar 

  19. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  20. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    CAS  Article  PubMed  Google Scholar 

  21. Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am J Epidemiol 135(11):1301–1309

    CAS  PubMed  Google Scholar 

  22. Girao LA, Ruck AC, Cantrill RC, Davidson BC (1986) The effect of C18 fatty acids on cancer cells in culture. Anticancer Res 6(2):241–244

    CAS  PubMed  Google Scholar 

  23. Puthier D, Bataille R, Barille S, Mellerin MP, Harousseau JL, Ponzio A, Robillard N, Wijdenes J, Amiot M (1996) Myeloma cell growth arrest, apoptosis, and interleukin-6 receptor modulation induced by EB1089, a vitamin D3 derivative, alone or in association with dexamethasone. Blood 88(12):4659–4666

    CAS  PubMed  Google Scholar 

  24. Park WH, Seol JG, Kim ES, Jung CW, Lee CC, Binderup L, Koeffler HP, Kim BK, Lee YY (2000) Cell cycle arrest induced by the vitamin D(3) analog EB1089 in NCI-H929 myeloma cells is associated with induction of the cyclin-dependent kinase inhibitor p27. Exp Cell Res 254(2):279–286

    CAS  Article  PubMed  Google Scholar 

  25. Park WH, Seol JG, Kim ES, Hyun JM, Jung CW, Lee CC, Binderup L, Koeffler HP, Kim BK, Lee YY (2000) Induction of apoptosis by vitamin D3 analogue EB1089 in NCI-H929 myeloma cells via activation of caspase 3 and p38 MAP kinase. Br J Haematol 109(3):576–583

    CAS  Article  PubMed  Google Scholar 

  26. Hirano T (1991) Interleukin 6 (IL-6) and its receptor: their role in plasma cell neoplasias. Int J Cell Cloning 9(3):166–184

    CAS  Article  PubMed  Google Scholar 

  27. Calder PC (1999) Dietary fatty acids and the immune system. Lipids 34(Suppl):S137–S140

    CAS  Article  PubMed  Google Scholar 

  28. Calder PC (1998) Dietary fatty acids and the immune system. Nutr Rev 56(1 Pt 2):S70–S83

    CAS  PubMed  Google Scholar 

  29. Rose DP, Connolly JM (1999) Omega-3 fatty acids as cancer chemopreventive agents. Pharmacol Ther 83(3):217–244

    CAS  Article  PubMed  Google Scholar 

  30. Miles EA, Calder PC (1998) Modulation of immune function by dietary fatty acids. Proc Nutr Soc 57(2):277–292

    CAS  Article  PubMed  Google Scholar 

  31. Wu S, Feng B, Li K, Zhu X, Liang S, Liu X, Han S, Wang B, Wu K, Miao D, Liang J, Fan D (2012) Fish consumption and colorectal cancer risk in humans: a systematic review and meta-analysis. Am J Med 125(6):551-e555–559-e555

    Article  Google Scholar 

  32. Geelen A, Schouten JM, Kamphuis C, Stam BE, Burema J, Renkema JM, Bakker EJ, van’t Veer P, Kampman E (2007) Fish consumption, n-3 fatty acids, and colorectal cancer: a meta-analysis of prospective cohort studies. Am J Epidemiol 166(10):1116–1125

    Article  PubMed  Google Scholar 

  33. Jiang G, Li B, Liao X, Zhong C (2013) Poultry and fish intake and risk of esophageal cancer: a meta-analysis of observational studies. Asia Pac J Clin Oncol. doi:10.1111/ajco.12114

    Google Scholar 

  34. Salehi M, Moradi-Lakeh M, Salehi MH, Nojomi M, Kolahdooz F (2013) Meat, fish, and esophageal cancer risk: a systematic review and dose–response meta-analysis. Nutr Rev 71(5):257–267

    Article  PubMed  Google Scholar 

  35. Gao M, Sun K, Guo M, Gao H, Liu K, Yang C, Li S, Liu N (2014) Fish consumption and n-3 polyunsaturated fatty acids, and risk of hepatocellular carcinoma: systematic review and meta-analysis. Cancer Causes Control. doi:10.1007/s10552-014-0512-1

    Google Scholar 

  36. Leung Yinko SS, Stark KD, Thanassoulis G, Pilote L (2014) Fish consumption and acute coronary syndrome: a meta-analysis. Am J Med 127(9):848-e842–857-e842

    Article  Google Scholar 

  37. Kolahdooz F, van der Pols JC, Bain CJ, Marks GC, Hughes MC, Whiteman DC, Webb PM, Australian Cancer S, the Australian Ovarian Cancer Study G (2010) Meat, fish, and ovarian cancer risk: results from 2 Australian case–control studies, a systematic review, and meta-analysis. Am J Clin Nutr 91(6):1752–1763

    Article  Google Scholar 

  38. Song J, Su H, Wang BL, Zhou YY, Guo LL (2014) Fish consumption and lung cancer risk: systematic review and meta-analysis. Nutr Cancer 66(4):539–549

    CAS  Article  PubMed  Google Scholar 

  39. Zheng JS, Hu XJ, Zhao YM, Yang J, Li D (2013) Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ 346:f3706

    Article  PubMed  Google Scholar 

  40. Yang H, Xun P, He K (2013) Fish and fish oil intake in relation to risk of asthma: a systematic review and meta-analysis. PLoS ONE 8(11):e80048

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  41. Li YH, Zhou CH, Pei HJ, Zhou XL, Li LH, Wu YJ, Hui RT (2013) Fish consumption and incidence of heart failure: a meta-analysis of prospective cohort studies. Chin Med J 126(5):942–948

    PubMed  Google Scholar 

  42. Djousse L, Akinkuolie AO, Wu JH, Ding EL, Gaziano JM (2012) Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. Clin Nutr 31(6):846–853

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  43. Chowdhury R, Stevens S, Gorman D, Pan A, Warnakula S, Chowdhury S, Ward H, Johnson L, Crowe F, Hu FB, Franco OH (2012) Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. BMJ 345:e6698

    PubMed Central  Article  PubMed  Google Scholar 

  44. Xun P, Qin B, Song Y, Nakamura Y, Kurth T, Yaemsiri S, Djousse L, He K (2012) Fish consumption and risk of stroke and its subtypes: accumulative evidence from a meta-analysis of prospective cohort studies. Eur J Clin Nutr 66(11):1199–1207

    CAS  Article  PubMed  Google Scholar 

  45. He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Goldbourt U, Greenland P (2004) Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke 35(7):1538–1542

    Article  PubMed  Google Scholar 

  46. Larsson SC, Orsini N (2011) Fish consumption and the risk of stroke: a dose–response meta-analysis. Stroke 42(12):3621–3623

    Article  PubMed  Google Scholar 

  47. Whelton SP, He J, Whelton PK, Muntner P (2004) Meta-analysis of observational studies on fish intake and coronary heart disease. Am J Cardiol 93(9):1119–1123

    Article  PubMed  Google Scholar 

  48. Bender N, Portmann M, Heg Z, Hofmann K, Zwahlen M, Egger M (2014) Fish or n3-PUFA intake and body composition: a systematic review and meta-analysis. Obes Rev 15(8):657–665

    CAS  Article  PubMed  Google Scholar 

  49. Torpy JM, Lynm C, Glass RM (2006) Eating fish: health benefits and risks. JAMA 296(15):1926

    CAS  Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by Liaoning Provincial Natural Science Foundation (Grant number: No.201202288 for Y-ZW) and the Younger research fund of Shengjing Hospital (Grant 2014sj09 for Qi-Jun Wu). We would like to thank Dr. Carlo La Vecchia for providing relevant information of their study.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Ya-Zhu Wang or Lang Wu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wang, YZ., Wu, QJ., Zhu, J. et al. Fish consumption and risk of myeloma: a meta-analysis of epidemiological studies. Cancer Causes Control 26, 1307–1314 (2015). https://doi.org/10.1007/s10552-015-0625-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-015-0625-1

Keywords

  • Diet
  • Epidemiology
  • Fish
  • Myeloma