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Journal of Oncology
Volume 2019, Article ID 7479518, 11 pages
https://doi.org/10.1155/2019/7479518
Review Article

The Protective Effect of Dietary Phytosterols on Cancer Risk: A Systematic Meta-Analysis

1Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
2Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
3Department of Plastic and Burns Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
4Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
5Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
6Department of Oncology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China

Correspondence should be addressed to Wei Wang; moc.361@rotcod-iewgnaw and Lingjun Zhu; nc.ude.umjn@nujgniluhz

Received 28 January 2019; Revised 18 May 2019; Accepted 30 May 2019; Published 23 June 2019

Academic Editor: Francesca De Felice

Copyright © 2019 Lu Jiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Backgrounds/Aims. Many studies have explored the association between dietary phytosterols and cancer risk, but the results have been inconsistent. We aimed to provide a synopsis of the current understanding of phytosterol intake for cancer risk through a systematic evaluation of the results from previous studies. Methods. We performed a literature search of PUBMED, EMBASE, CNKI, and Wanfang, and studies published before May 2019 focusing on dietary total phytosterols, β-sitosterol, campesterol, stigmasterol, β-sitostanol, and campestanol, as well as their relationships with cancer risk, were included in this meta-analysis. Summaries of the relative risks from 11 case-control and case-cohort studies were eventually estimated by randomized or fixed effects models. Results. The summary relative risk for the highest versus the lowest intake was 0.63 (95% confidence interval [CI] = 0.49–0.81) for total phytosterols, 0.74 (95% CI = 0.54–1.02) for β-sitosterol, 0.72 (95% CI = 0.51–1.00) for campesterol, 0.83 (95% CI = 0.60–1.16) for stigmasterol, 1.12 (95% CI = 0.96–1.32) for β-sitostanol, and 0.77 (95% CI = 0.65–0.90) for campestanol. In a dose-response analysis, the results suggested a linear association for campesterol and a nonlinear association for total phytosterol intake. Conclusion. Our findings support the hypothesis that high phytosterol intake is inversely related to risk of cancer. Further studies with prospective designs that control for vital confounders and investigate the important anticancer effects of dietary phytosterols are warranted.