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Association Between Coffee Intake After Diagnosis of Colorectal Cancer and Reduced Mortality

  • Yang Hu
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Ming Ding
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Chen Yuan
    Affiliations
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Kana Wu
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Stephanie A. Smith-Warner
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Frank B. Hu
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Channing Division of Network Medicine, Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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  • Andrew T. Chan
    Affiliations
    Channing Division of Network Medicine, Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts

    Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Jeffrey A. Meyerhardt
    Affiliations
    Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
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  • Shuji Ogino
    Affiliations
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts

    Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts
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  • Charles S. Fuchs
    Affiliations
    Yale Cancer Center, New Haven, Connecticut

    Department of Medicine, Yale School of Medicine, New Haven, Connecticut

    Smilow Cancer Hospital, New Haven, Connecticut
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  • Edward L. Giovannucci
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Channing Division of Network Medicine, Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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  • Mingyang Song
    Correspondence
    Reprint requests Address requests for reprints to: Mingyang Song, ScD, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Bartlett Ext., Room 906, 55 Fruit Street, Boston, Massachusetts 02114. fax: (617) 432–2435.
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

    Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
Published:November 20, 2017DOI:https://doi.org/10.1053/j.gastro.2017.11.010

      Background & Aims

      Few studies have examined the association between coffee intake and survival after diagnosis of colorectal cancer (CRC). We performed a prospective study to investigate the association between coffee intake after a diagnosis of CRC and mortality.

      Methods

      We collected data from the Nurses’ Health Study (1984–2012) and Health Professionals Follow-up Study (1986–2012), following 1599 patients diagnosed with stage 1, 2, or 3 CRC. CRC was reported on questionnaires and ascertained by review of medical records and pathology reports; intake of food and beverages was determined from responses to semi-quantitative food frequency questionnaires. Participants were asked how often during the previous year that they consumed coffee, with 1 cup as the standard portion size. The first questionnaire response collected at least 6 months but not more than 4 years after diagnosis was used for assessment of post-diagnostic intake (median time from diagnosis to the dietary assessment, 2.2 years). The last semi-quantitative food frequency questionnaire prior to diagnosis was used to assess pre-diagnostic dietary intake.

      Results

      During a median of 7.8 years of follow-up, we documented 803 deaths, of which 188 were because of CRC. In the multivariable adjusted models, compared with nondrinkers, patients who consumed at least 4 cups of coffee per day had a 52% lower risk of CRC-specific death (hazard ratio [HR] 0.48; 95% CI, 0.28–0.83; P for trend=.003) and 30% reduced risk of all-cause death (HR, 0.70; 95% CI, 0.54–0.91; P for trend <.001). High intake of caffeinated and decaffeinated coffee (2 or more cups/day) was associated with lower risk of CRC-specific mortality and all-cause mortality. When coffee intake before vs after CRC diagnosis were examined, compared with patients consistently consuming low amounts (less than 2 cups/day), those who maintained a high intake (2 or more cups/day) had a significantly lower risk of CRC-specific death (multivariable HR, 0.63; 95% CI, 0.44–0.89) and death from any cause (multivariable HR, 0.71; 95% CI, 0.60–0.85).

      Conclusions

      In an analysis data from the Nurses’ Health Study and Health Professionals Follow-up Study, we associated intake of caffeinated and decaffeinated coffee after diagnosis of CRC with lower risk of CRC-specific death and overall death. Studies are needed to determine the mechanisms by which coffee might reduce CRC progression.

      Graphical abstract

      Keywords

      Abbreviations used in this paper:

      BMI (body mass index), CRC (colorectal cancer), GI (glycemic index), GL (glycemic load), HPFS (Health Professionals Follow-up Study), HR (hazard ratio), MET (metabolic equivalent), NHS (Nurses’ Health Study), sFFQ (semi-quantitative food frequency questionnaire)
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