Journal Article

Problems with the Assessment of Dietary Fat in Prostate Cancer Studies

Leslie K. Dennis, Linda G. Snetselaar, Brian J. Smith, Ron E. Stewart and Michael E. C. Robbins

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 160, issue 5, pages 436-444
Published in print September 2004 | ISSN: 0002-9262
Published online September 2004 | e-ISSN: 1476-6256 | DOI:
Problems with the Assessment of Dietary Fat in Prostate Cancer Studies

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The authors conducted a detailed review of studies on the association between prostate cancer and total dietary fat along with specific fatty acids. Overall, the 29 studies reporting actual dietary fat levels in grams of fat were heterogeneous, suggesting that pooling of the relative risks may be inappropriate. Heterogeneity was also seen by study design. More specifically, although the pooled estimate for prostate cancer and an increase of 45 g in total fat consumption per day was small (relative risk = 1.2), heterogeneity between studies was large, and the association was not supported by specific fatty acids. The strongest association was found among the five extremely inconsistent studies of alpha-linolenic fatty acid. The associations with advanced prostate cancer were more homogeneous and suggest a relation with total and saturated fat but none with specific fatty acids. This review highlights the inconsistent way in which total dietary fat and specific fatty acids have been measured and reported across epidemiologic studies of prostate cancer. The heterogeneity between studies was large, possibly because of the variation in the dietary instruments used and the corresponding databases (nondifferential misclassification), recall bias, differing case definitions, residual confounding, or potential selection bias in different studies.

Keywords: dietary fats; meta-analysis; prostatic neoplasms; review literature; Abbreviations: FFQ, food frequency questionnaire; lnRR, natural log of the relative risk estimate.

Journal Article.  6746 words.  Illustrated.

Subjects: Public Health and Epidemiology

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