Coffee consumption may lower risk for death in advanced, metastatic colorectal cancer
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Drinking coffee may reduce the risk for disease progression and death among patients with advanced or metastatic colorectal cancer, according to results of a prospective observational cohort study published in JAMA Oncology.
“We have some hypotheses regarding why this association exists, such as the high antioxidant content of coffee or caffeine’s insulin-sensitizing effects, which other research has implicated in cancer development,” Christopher Mackintosh, MLA, medical student at Mayo Clinic, told Healio. “However, our study was not designed to test such hypotheses.”
Previous studies have shown associations between coffee intake and reduced risks for colorectal cancer recurrence and mortality. However, a correlation between coffee consumption and survival among patients with advanced or metastatic disease had not been established.
Mackintosh and colleagues studied the potential role of total, caffeinated or decaffeinated coffee consumption in reducing risks for disease progression and mortality among 1,171 patients (median age, 59 years; interquartile range [IQR], 51-67; 59% men; 86% white) with previously untreated locally advanced or metastatic colorectal cancer.
All patients participated in the randomized, phase 3 Cancer and Leukemia Group B/SWOG 80405 trial, which compared the addition of cetuximab (Erbitux, Eli Lilly) and/or bevacizumab (Avastin, Genentech) to standard chemotherapy. Participants in the trial used a semiquantitative food frequency questionnaire to report dietary intake at the time of enrollment.
OS and PFS served as the primary endpoints of the current analysis.
Overall, 1,092 patients (93%) died or experienced disease progression.
Median follow-up among surviving patients was 5.4 years (IQR, 3.2-6.3).
Results showed associations of increased consumption of coffee with decreased risks for cancer progression (HR for 1-cup-per-day increment = 0.95; 95% CI, 0.91-1) and death (HR for 1-cup-per-day increment = 0.93; 95% CI, 0.89-0.98).
Patients who drank two to three cups per day, compared with never-drinkers, had a multivariable HR for OS of 0.82 (95% CI, 0.67-1) and for PFS of 0.82 (95% CI, 0.68-0.99). Patients who drank at least four cups of coffee per day had a multivariable HR for OS of 0.64 (95% CI, 0.46-0.87) and for PFS of 0.78 (95% CI, 0.59-1.05).
Researchers observed similar significant associations in individual analyses of caffeinated and decaffeinated coffee intake.
“Based on these results alone, I would not suggest that patients drastically alter or increase their consumption of coffee,” Mackintosh said. “I would say that patients who already enjoy drinking coffee can feel OK about continuing to do so even after diagnosis with metastatic colorectal cancer, without fear of worsening their prognosis. As always, patients should speak with their personal physicians and health care teams regarding individualized dietary recommendations.”
Coffee is unique in nutrition and health research because it is widely consumed globally. Therefore, incorporating coffee drinking into colorectal cancer treatment strategies has practical appeal, although more research is needed, Erikka Loftfield, PhD, MPH, research fellow in the metabolic epidemiology branch at NCI, and colleagues wrote.
“In the meantime, the findings of [this study] should reassure [colorectal cancer] survivors who drink coffee and stimulate further research on coffee and cancer development and survival.”
References:
- Loftfield E, et al. JAMA Oncol. 2020;doi:10.1001/jamaoncol.2020.3313.
- Mackintosh C, et al. JAMA Oncol. 2020;doi:10.1001/jamaoncol.2020.3938.
For more information:
Christopher Mackintosh, MLA, can be reached at mackintosh.christopher@mayo.edu.
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