Higher Coffee Intake Associated With Significantly Reduced Cancer Recurrence and Increased Survival in Patients With Late-Stage Colon Cancer
A large observational study investigating the effect of coffee consumption on advanced-stage colon cancer and survival has found that patients who drank four or more cups of coffee a day were 42% less likely to experience a recurrence than non-coffee drinkers and were 33% less likely to die from their cancer or any other cause. Although why caffeine had this effect on patients is not clear, the researchers hypothesized that caffeine consumption increases the body’s sensitivity to insulin, so less of it is needed and may reduce inflammation and the risk of diabetes and cancer. The findings by Guercio et al offer insight into the role diet and lifestyle may play in colon cancer patient outcome. The study is published in the Journal of Clinical Oncology.
Study Methodology
Between 1999 and 2001, 953 patients with stage III colon were enrolled in this study. The patients were participants in the Alliance for Clinical Trials in Oncology adjuvant therapy trial for stage III colon cancer, comparing therapy with weekly fluorouracil (5-FU) and leucovorin to weekly irinotecan, 5-FU, and leucovorin. Patients who underwent a complete surgical resection of their primary tumor within 56 days of trial entry, had regional lymph node metastases without evidence of distant metastases, had a baseline Eastern Cooperative Oncology Group performance status of 0 to 2, and had adequate bone marrow, renal, and hepatic function were eligible for this study.
The patients were asked to complete a food frequency questionnaire during and 6 months after adjuvant therapy that captured diet and lifestyle habits, including intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items.
The researchers examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards.
Study Results
The study found that patients consuming at least four cups of coffee per day experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% confidence interval [CI] = 0.34–0.99), compared with never-drinkers (P = .002). Patients consuming at least four cups of caffeinated coffee per day experienced significantly reduced cancer recurrence or mortality risk compared to abstainers (HR = 0.48; 95% CI = 0.25–0.91, P = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR = 0.66 across extreme quintiles; 95% CI = 0.47–0.93, P = .006).
Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes appeared consistent across other predictors of cancer recurrence and mortality.
According to the study abstract, the researchers’ findings of the association between increasing coffee intake and a significant improvement in cancer recurrence or mortality and all-cause mortality appeared confined to caffeinated coffee intake.
“These associations were independent of other predictors of patient outcome, diet, and lifestyle factors. Moreover, the effect of total coffee intake was largely maintained across other known or suspected predictors of cancer recurrence,” wrote the study authors.
“Although our observational study does not offer conclusive evidence for causality, our findings potentially inform colon cancer biology and offer further insight into the role of diet and lifestyle in colon cancer patient outcome. Further studies are needed to confirm our findings,” concluded the authors.
Charles S. Fuchs, MD, MPH, Director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute, is the corresponding author of this study.
Funding for this study was provided by the National Cancer Institute, the National Institutes of Health, the Perry S. Levy Fund for Gastrointestinal Cancer Research, and Pharmacia & Upjohn Company. For full disclosures of the study authors, visit jco.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
