Fish consumption and risk of esophageal cancer and its subtypes: a systematic review and meta-analysis of observational studies

Eur J Clin Nutr. 2013 Feb;67(2):147-54. doi: 10.1038/ejcn.2012.213. Epub 2013 Jan 16.


Background/objectives: Inconsistent results regarding the association between fish intake and risk of subtypes of esophageal cancer (EC), esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), have been reported. To provide a quantitative assessment of this association, we summarized the evidence from observational studies.

Subjects/methods: Relevant studies were identified in MEDLINE and EMBASE until 31 May, 2012. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were pooled with a random-effects model. Between-study heterogeneity was assessed using the Cochran's Q and I(2) statistics.

Results: A total of 24 studies (21 case-control and 3 cohort studies) were included in this systematic review and meta-analysis. The SRRs of ESCC were 0.81 (95% CI: 0.66-0.99) for those in the highest fish consumption category compared with those in the lowest consumption category, with significant heterogeneity among studies (P(heterogeneity)=0.007, I(2)=51.9%). Subgroup analysis suggested that a weak association between fish consumption and ESCC risk was shown in hospital-based case-control studies, but not in population-based case-control or cohort studies. According to high vs low analysis, fish consumption had no relationship with EAC risk (SRR=0.86, 95% CI: 0.61-1.22).

Conclusions: Our results suggest that fish consumption is not appreciably related to risk of both ESCC and EAC.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Carcinoma, Squamous Cell / etiology*
  • Diet* / adverse effects
  • Energy Intake*
  • Esophageal Neoplasms / etiology*
  • Feeding Behavior*
  • Fishes*
  • Humans
  • Risk Factors
  • Seafood* / adverse effects