SYSTEMATIC REVIEW ON ROLE OF OMEGA 3 FATTY ACIDS IN COLORECTAL CANCER

Document Type

Conference Proceeding

Publication Date

10-1-2025

Publication Title

United European Gastroenterol J

Keywords

cyclooxygenase 2, fatty acid, omega 3 fatty acid, adult, aged, animal experiment, antiapoptotic activity, antineoplastic activity, cancer inhibition, cancer risk, colon cancer, colorectal cancer, conference abstract, controlled study, drug therapy, female, fish consumption, follow up, human, human tissue, inflammation, male, observational study, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, randomized controlled trial, side effect, systematic review

Abstract

Introduction: Omega-3 fatty acids, especially polyunsaturated have shown anticarcinogenic properties in animal studies. Observational studies in humans show no overall association with colorectal cancer. However, there is a small inverse association between fish intake, a dietary source of Omega-3 fatty acids, and colorectal cancer risk when followed over long duration. These fatty acids downregulate the inflammatory cascade through inhibition of prostaglandin-endoperoxide synthase 2 responsible for the anticancer properties. Aims & Methods: Authors researched PubMed, Google Scholar, Cochrane and Scopus and retrieved articles from the last 7 years with omega 3 FA use in patients at risk of CRC or pre-existing CRC to monitor outcomes. 4 RCTs were finalized. Prisma guidelines were adhered to and the risk of bias (RoB) using Cochrane RoB tool 2 was low. Results: Alliance trial showed patients with high intake of marine Omega- 3 PUFAs and dark fish after colon cancer diagnosis may have longer Disease-Free Survival (DFS). Further a subgroup analysis of this trial showed improved 3-year DFS for wild KRAS mutation but p<.05 proved it to be insignificant. Non-KAS tumors, however, showed a hazard ratio of 1.3 with a p=.02, indicating inverse correlation. Higher consumption was associated with better 3-year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). Pre-operative use was associated with higher infections in trial NCT02231203. Interestingly, trial 4, NCT01661764 was done to study anti- apoptotic effects but no significant association was seen despite excess cell growth in the crypts upon endoscopic studies. These fatty acids have variable mechanisms of actions to explain pro and anti-apoptotic effects. Limited studies have mostly failed to meet the deadlines. Side effects were noted making peri- operative use limited. Conclusion: Further large RCTs with long follow-ups to monitor effects on cancer outcomes, side effect profile, and possible pro-malignant effects. Based on limited data, current evidence shows insignificant benefits for omega-3 fatty acids. However, KRAS and MMR mutation subgroups showed a favorable response warranting more research in this population.

Volume

13

Issue

Supplement 8

First Page

570

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