Gastroenterology ( IF 29.4 ) Pub Date : 2017-11-20 , DOI: 10.1053/j.gastro.2017.11.010 Yang Hu 1 , Ming Ding 2 , Chen Yuan 3 , Kana Wu 2 , Stephanie A Smith-Warner 1 , Frank B Hu 4 , Andrew T Chan 5 , Jeffrey A Meyerhardt 6 , Shuji Ogino 7 , Charles S Fuchs 8 , Edward L Giovannucci 4 , Mingyang Song 9
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.
中文翻译:
诊断结直肠癌后咖啡摄入量与死亡率降低之间的关系
背景与目标
很少有研究探讨咖啡摄入量与结直肠癌 (CRC) 诊断后生存率之间的关系。我们进行了一项前瞻性研究,调查结直肠癌诊断后咖啡摄入量与死亡率之间的关系。
方法
我们从护士健康研究(1984-2012)和健康专业人员随访研究(1986-2012)中收集了数据,对 1599 名诊断为 1、2 或 3 期 CRC 的患者进行了跟踪调查。CRC 通过调查问卷进行报告,并通过病历和病理报告的审查来确定;食物和饮料的摄入量是根据半定量食物频率调查问卷的答复确定的。参与者被问及在过去的一年里他们喝咖啡的频率,以 1 杯为标准份量。诊断后至少 6 个月但不超过 4 年收集的第一份问卷答复用于评估诊断后摄入量(从诊断到饮食评估的中位时间为 2.2 年)。诊断前的最后一次半定量食物频率调查问卷用于评估诊断前的饮食摄入量。
结果
在平均 7.8 年的随访期间,我们记录了 803 例死亡,其中 188 例死于结直肠癌。在多变量调整模型中,与不饮酒者相比,每天至少喝 4 杯咖啡的患者 CRC 特异性死亡风险降低 52%(风险比 [HR] 0.48;95% CI,0.28–0.83;P为趋势=.003),全因死亡风险降低 30%(HR,0.70;95% CI,0.54–0.91;趋势P <.001)。大量摄入含咖啡因和不含咖啡因的咖啡(每天 2 杯或更多杯)与结直肠癌特异性死亡率和全因死亡率风险降低相关。当检查 CRC 诊断之前和之后的咖啡摄入量时,与持续摄入少量咖啡(每天少于 2 杯)的患者相比,那些保持高摄入量(每天 2 杯或更多杯)的患者患 CRC 特异性的风险显着降低死亡(多变量 HR,0.63;95% CI,0.44–0.89)和任何原因死亡(多变量 HR,0.71;95% CI,0.60–0.85)。
结论
在护士健康研究和健康专业人员随访研究的分析数据中,我们将诊断 CRC 后摄入含咖啡因和不含咖啡因的咖啡与较低的 CRC 特异性死亡和总体死亡风险联系起来。需要研究来确定咖啡可能减缓结直肠癌进展的机制。