International Journal of Epidemiology 2000;29:615-621
© International Epidemiological Association 2000
Fish consumption is inversely associated with male lung cancer mortality in countries with high levels of cigarette smoking or animal fat consumption
Department of Epidemiology, School of Public Health, Catholic University of Leuven, Leuven, Belgium.
Reprint request to: Prof. Hugo Kesteloot, Department of Epidemiology, Kapucijnenvoer 33, B-3000 Leuven, Belgium. E-mail: hugo.kesteloot{at}med.kuleuven.ac.be
Background A striking difference in fish consumption and lung cancer mortality (LCM) exists among populations worldwide. This study investigated the relation between fish consumption and LCM at the population level.
Methods Sex-specific LCM data, mostly around 1993 and fish consumption data for 10 periods 1961–1994 in 36 countries were obtained from WHO and FAO, respectively.
Results A significant inverse correlation exists between log fish consumption and LCM rate in 9 out of the 10 time periods (r = –0.34 to r = –0.46, P = 0.044 to P = 0.005). After adjusting for smoking and other confounders, log fish consumption (% of total energy [% E]) was inversely and significantly associated with LCM rate (per 100 000 per year) in all 10 time periods (ß = –26.3 to ß = –36.7; P = 0.0039 to P < 0.0001). The stratified analysis showed that this inverse relation was significant only in countries with above median level of smoking (>2437 cigarettes/adult/year) or animal fat minus fish fat consumption (22.4% E). An increase in fish consumption by 1% E was calculated to reduce mean male LCM rate of the populations examined in the age class of 45–74 years by 8.4%. In women, no significant relation between fish consumption and LCM could be established.
Conclusions Fish consumption is associated with a reduced risk from LCM, but this possible protective effect is clear-cut only in men and in countries with high levels of cigarette smoking or animal fat consumption.
Keywords Animal fat, cigarette smoking, fish consumption, lung cancer mortality
Accepted 7 February 2000
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