Change in marine ω-3 polyunsaturated fatty acid intake after diagnosis and colorectal cancer-specific and all-cause mortality
| Decrease of ≥0.15 g/day | Decrease of 0.02–0.14 g/day | Change of <0.02 g/day | Increase of 0.02–0.14 g/day | Increase of ≥0.15 g/day | p for trend* | |
|---|---|---|---|---|---|---|
| Median intake (Interquartile range) | −0.25 (−0.41 to −0.20) | −0.06 (−0.10 to −0.03) | 0 (−0.01 to 0.01) | 0.06 (0.04 to 0.10) | 0.37 (0.20 to 0.62) | |
| Person-years | 2271 | 3670 | 2208 | 2945 | 2477 | |
| Colorectal cancer-specific mortality | ||||||
| Deaths (n=169) | 36 | 51 | 35 | 34 | 13 | |
| Age-adjusted HR (95% CI)† | 1.02 (0.55 to 1.89) | 1.02 (0.63 to 1.63) | 1 (referent) | 0.96 (0.57 to 1.61) | 0.28 (0.13 to 0.57) | <0.001 |
| Multivariable-adjusted HR (95% CI)‡ | 1.10 (0.59 to 2.08) | 1.16 (0.71 to 1.91) | 1 (referent) | 1.10 (0.64 to 1.89) | 0.30 (0.14 to 0.64) | <0.001 |
| All-cause mortality | ||||||
| Deaths (n=561) | 108 | 161 | 88 | 127 | 77 | |
| Age-adjusted HR (95% CI)† | 1.26 (0.91 to 1.75) | 1.25 (0.95 to 1.65) | 1 (referent) | 1.24 (0.93 to 1.65) | 0.82 (0.59 to 1.13) | 0.005 |
| Multivariable-adjusted HR (95% CI)‡ | 1.21 (0.86 to 1.69) | 1.23 (0.93 to 1.63) | 1 (referent) | 1.21 (0.90 to 1.62) | 0.87 (0.62 to 1.21) | 0.03 |
*p for trend was calculated using median intake for each category of marine ω-3 polyunsaturated fatty acid intake.
†Cox proportional hazards regression model stratified by age groups at diagnosis (<60, 60–64, 65–69, 70–74 and ≥75 years), sex and cancer stage (I, II, III, IV and unspecified) with additional adjustment for age at diagnosis (continuous).
‡Further adjusted for prediagnostic intake of marine ω-3 polyunsaturated fatty acids (continuous), grade of differentiation (1–3 and unspecified), subsite (proximal colon, distal colon, rectum and unspecified), pack-years of smoking (0, 1–15, 16–25, 26–45, >45), alcohol consumption (<0.15, 0.15–1.9, 2.0–7.4, ≥7.5 g/day), BMI (<23, 23–24.9, 25–27.4, 27.5–29.9, ≥30 kg/m2), physical activity (women: <5, 5–11.4, 11.5–21.9, ≥22 MET-hours/week; men: <7, 7–14.9, 15–24.9, ≥25 MET-hours/week), regular use of aspirin and NSAIDs (yes or no), postmenopausal hormone use (women only: never, current, past users) and intake of folate and vitamin D (in quartiles).
BMI, body mass index; MET, metabolic equivalent; NSAIDs, non-steroidal anti-inflammatory drugs.