Caffeinated Coffee Drinking Linked to Lower Risk for Head and Neck Cancers

Laurie Barclay, MD

July 08, 2010

July 8, 2010 — Caffeinated coffee drinking is linked to lower risk for head and neck cancers, according to the results of a pooled analysis of case-control studies reported online June 22 in Cancer Epidemiology, Biomarkers & Prevention.

"Tobacco smoking and alcohol drinking are the major risk factors for cancers of the oral cavity and pharynx and of the larynx (head and neck cancers), and together are responsible of ~75% of cases diagnosed in North America and Europe; however, other dietary and lifestyle factors, including other types of beverages, such as matè, may also play a role," write Carlotta Galeone, PhD, from Università degli Studi di Milano in Milan, Italy, and colleagues. "Only a few studies have explored the relation between coffee and tea intake and head and neck cancers, with inconsistent results."

Using 9 case-control studies of head and neck cancers, the investigators pooled individual-level data from 5139 patients with cancer and 9028 controls, using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjustment for potential confounders.

Drinking caffeinated coffee was inversely associated with risk for oral cavity or pharyngeal cancer. Compared with no coffee intake, ORs were 0.96 (95% CI, 0.94 - 0.98) for an increment of 1 cup per day and 0.61 (95% CI, 0.47 - 0.80) for consumption of more than 4 cups per day. The OR was 0.46 for oral cavity cancer (95% CI, 0.30 - 0.71), 0.58 for cancer of the oropharynx/hypopharynx (95% CI, 0.41 - 0.82), and 0.61 for cancer of the oral cavity/pharynx not otherwise specified (95% CI, 0.37 - 1.01). Findings were similar across strata of selected covariates.

Laryngeal cancer was not associated with caffeinated coffee drinking (OR, 0.96; 95% CI, 0.64 - 1.45 in drinkers of >4 cups per day vs nondrinkers). There appeared to be no increased risk for cancer with decaffeinated coffee, but there were too few data for detailed analysis. No relationship was shown between tea drinking and head and neck cancer risk.

"This pooled analysis of case-control studies supports the hypothesis of an inverse association between caffeinated coffee drinking and risk of cancer of the oral cavity and pharynx," the study authors write. "Given widespread use of coffee and the relatively high incidence and low survival of head and neck cancers, the observed inverse association may have appreciable public health relevance."

Limitations of this meta-analysis include possible bias, confounding, reverse causality, heterogeneity among the selected studies, and lack of good-quality data on duration of coffee drinking or other time-related factors of the exposure in several studies.

"Given the widespread use of coffee and the high incidence and low survival of head and neck cancers, it is important to conclusively establish whether the observed association between caffeinated coffee drinking and head and neck cancer risk is causal, as this would have appreciable public health relevance, although alcohol and tobacco remain the key risk factors for cancer of the oral cavity and pharynx in most populations," the study authors conclude.

This International Head and Neck Cancer Epidemiology Consortium was supported by the National Cancer Institute in the National Institutes of Health. The individual studies were supported by the Italian Association for Research on Cancer, Swiss Cancer League, Italian Association for Research on Cancer, Italian League Against Cancer, Italian Ministry of Research, Swiss Research Against Cancer/Oncosuisse, National Institutes of Health, Alper Research Program for Environmental Genomics of the University of California–Los Angeles Jonsson Comprehensive Cancer Center, and Intramural Program of the National Cancer Institute. The study authors have disclosed no relevant financial relationships.

Cancer Epidemiol Biomarkers Prev. Published online June 22, 2010.

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