Patients with colorectal cancer who drank coffee, either caffeinated or decaffeinated, showed a lower risk for colorectal cancer-specific death and overall death in two large prospective cohort studies.
The benefits were strongest in patients who drank at least two cups per day both before and after their diagnosis.
“For patients with non-metastatic colorectal cancer (stage I, II, or III) consulting for nutrition advice, physicians may consider encouraging patients without contradictions to take coffee (with or without caffeine), because we found patients with higher coffee intake in both the pre- and post-diagnostic period might benefit most for longer survival,” Yang Hu, MS, of the departments of nutrition and epidemiology at Harvard T.H. Chan School of Public Health in Boston, told Healio Gastroenterology and Liver Disease. “The bottom line is that it’s important for patients to keep their drinking habits after diagnosis of colorectal cancer, and the abstainers without contradiction can also consider adding coffee to their usual diet because at least it won’t have adverse effects on survival.”
To evaluate the relationship between coffee intake after CRC diagnosis and mortality, Hu and colleagues analyzed data on 1,599 patients diagnosed with stage I or II CRC during follow-up in the Nurses’ Health Study (1984-2012) and the Health Professionals Follow-up Study (1986-2012). Participants reported their coffee consumption before their CRC diagnosis, and between 6 months and 4 years after diagnosis (median, 2.2 years). Overall, the participants reported drinking a median of one cup per day.
Of 803 patients who died during a median follow-up of 7.8 years, 188 died of CRC.
After adjusting for demographic, lifestyle and other factors, multivariable analysis showed that patients who drank four or more cups of coffee per day were 52% less likely to die of CRC (HR = 0.48; 95% CI, 0.28–0.83; P for trend = .003) and 30% less likely to die of any cause (HR = 0.7; 95% CI, 0.54–0.91; P for trend < .001) compared with those who did not drink coffee.
Hu and colleagues also observed these benefits among those who drank at least two cups per day, and those who maintained this level of consumption before and after CRC diagnosis showed significantly lower odds of CRC-specific death (HR = 0.63; 95% CI, 0.44–0.89) and all-cause mortality (HR = 0.71; 95% CI, 0.6–0.85) vs. those who consistently drank less than two cups per day before and after diagnosis.
Prior research has suggested that coffee may protect against CRC due to its anti-inflammatory and insulin-sensitizing properties, and the anti-carcinogenic substances it contains including polyphenols, diterpenes, melanoidins, and antioxidants, “which may be beneficial in improving CRC survival by ameliorating systemic disturbances due to metabolic reprogramming of cancer or by promoting an anti-carcinogenic microenvironment that slows down tumor progression,” Hu and colleagues wrote.
“We also found that the beneficial association of post-diagnostic coffee intake with survival appeared to be stronger among stage III patients than stage I or II patients,” they added. “Although the exact mechanisms remain unclear, the findings are unlikely to be explained by reverse causality (ie, patients with more severe disease tend to avoid stimulating beverages such as coffee) because total coffee intake did not vary by cancer stages and the HRs were virtually unchanged after excluding patients who died within 3 years after diagnosis.”
They concluded that further research is needed to confirm these findings and explore the underlying mechanism driving coffee’s benefits to CRC prognosis. – by Adam Leitenberger
Disclosures: The authors report no relevant financial disclosures.