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Higher coffee intake lowers risk for mortality in patients with colorectal cancer

Both caffeinated and decaffeinated coffee correlated with a lower risk for all-cause mortality and colorectal cancer-specific mortality after CRC diagnosis, according to recently published data.

Mingying Song

“Findings from the current study substantiates the potential role of coffee intake in improving survival for patients with established colorectal cancer,” Mingyang Song, MD, ScD, told Healio.com/Hepatology. “Our results may have important clinical implications because very few dietary factors have been identified to be associated with improved colorectal cancer prognosis.”

Song and colleagues identified 1,027 patients diagnosed with stage 1 to 3 colorectal cancer from the Nurses’ Health Study (NHS) and 572 from the Health Professionals Follow-up Study cohorts to assess the effects of coffee intake on mortality. Information on chemotherapy was available for 397 patients from the NHS cohort.

The researchers assessed the consumption of caffeinated and decaffeinated coffee separately using data from simplified food frequency questionnaires. The possible responses regarding coffee intake ranged from never or less than one time per month to drinking coffee six or more times a day.

Additionally, the researchers considered the strong association between cigarette smoking and coffee intake related to CRC survival and performed a stratified analysis by post-diagnostic smoking status to minimize the potential confounding effect. Patients with a higher total coffee intake after CRC diagnosis were more likely to be current smokers.

“Mechanistically, many bioactive compounds in coffee such as caffeic acid, kahweol, and melanoidins may contribute to the observed inverse associations as they may help improve insulin resistance, ameliorate inflammation, and inhibit cancer invasion and distant spread,” Song said.

The researchers document 803 total deaths and 188 CRC-specific deaths during a median of 7.8 years.

Compared with those who answered that they never drank coffee or drank less than one time per month, patients who drank at least four cups per day had a 52% lower risk for CRC-specific mortality (HR = 0.48; 95% CI, 0.28-0.83) and a 30% lower risk for all-cause mortality (HR = 0.7; 95% CI, 0.54-0.91).

The researchers observed similar associations between caffeinated coffee regarding CRC-specific mortality (HR = 0.61; 95% CI, 0.4-0.91) and all-cause mortality (HR = 0.75; 95% CI, 0.62-0.91) and decaffeinated coffee regarding CRC-specific (HR = 0.61; 95% CI, 0.38-0.97) and all-cause mortality (HR = 0.7; 95% CI, 0.55-0.87) when they compared patients who drank two or more cups of coffee per day with those who never drank coffee.

After the researchers stratified patients by cancer stage, they found an inverse association between total coffee intake and mortality, which appeared significantly stronger among patients with stage 3 compared with patients with stage 1 or 2 cancers for both CRC-specific mortality (P = .07) and all-cause mortality (P = .02).

Among patients with stage 3 CRC, each cup per day increase of total coffee intake correlated with an 18% lower risk for CRC-specific mortality (HR = 0.82; 95% CI, 0.68-1) and 20% lower risk for all-cause mortality (HR = 0.8; 95% CI, 0.69-0.91).

Patients who maintained higher total coffee intake after CRC diagnosis also had a 37% lower risk for CRC-specific mortality (HR = 0.63; 95% CI, 0.44-0.89) compared with those who consistently consumed less than two cups per day before and after diagnosis.

“A clear dose-response relationship was found between higher coffee intake and lower mortality,” Song concluded. “Viewed clinically, once our findings are validated by further studies (preferably randomized clinical trials), for patients with non-metastasis colorectal cancer (stage 1 to 3) consulting for nutrition advice, physicians may consider encouraging patients without contradictions to increase coffee intake, because we found patients with higher coffee intake in both pre- and post-diagnostic period might benefit most for longer survival.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.