Abstract
Coffee consumption has been associated with a reduced risk of developing colorectal cancer (CRC). However, it is not clear whether coffee consumption is related to CRC progression. Hence, we assessed the association of coffee consumption with CRC recurrence and all-cause mortality using data from a prospective cohort study of 1719 stage I–III CRC patients in the Netherlands. Coffee consumption and other lifestyle characteristics were self-reported using questionnaires at the time of diagnosis. We retrieved recurrence and all-cause mortality data from the Netherlands Cancer Registry and the Personal Records Database, respectively. Cox proportional hazard regression models with and without restricted cubic splines were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, education, smoking status, cancer stage and tumor location. We observed 257 recurrences during a 6.2-year median follow-up and 309 deaths during a 6.6-year median follow-up. Consuming more than 4 cups/d of coffee compared to an intake of <2 cups/d was associated with a 32% lower risk of CRC recurrence (95% CI: 0.49, 0.94,). The association between coffee consumption and all-cause mortality was U-shaped; coffee intake seemed optimal at 3–5 cups/d with the lowest risk at 4 cups/d (HR: 0.68, 95% CI: 0.53, 0.88).
Our results suggest that coffee consumption may be associated with a lower risk of CRC recurrence and all-cause mortality. The association between coffee consumption and all-cause mortality appeared nonlinear. More studies are needed to understand the mechanism by which coffee consumption might improve CRC prognosis.
What's new?
Although existing evidence suggests that coffee consumption may lower colorectal cancer risk, the association with colorectal cancer prognosis remains unclear. This large prospective study of stage I–III patients in a country with a relatively high coffee intake revealed a strong inverse association between coffee consumption and colorectal cancer recurrence. The association between coffee consumption and all-cause mortality in colorectal cancer patients was nonlinear, suggesting an optimal intake of three to five cups per day. The findings could potentially inform future intervention studies as well as dietary guidelines for colorectal cancer patients.
AUTHOR CONTRIBUTIONS
Conceptualization, Abisola M. Oyelere, Dieuwertje E. Kok, Fränzel J. B. van Duijnhoven, Ellen Kampman; methodology, Abisola M. Oyelere, Dieuwertje E. Kok, Fränzel J. B. van Duijnhoven, Ellen Kampman; validation, Abisola M. Oyelere, Dieuwertje E. Kok, Fränzel J. B. van Duijnhoven, Ellen Kampman; formal analysis, Abisola M. Oyelere; investigation Abisola M. Oyelere; resources, Johannes H. W.de Wilt, Henk K. van Halteren, Ewout A. Kouwenhoven; data curation, Abisola M. Oyelere; writing-original draft preparation, Abisola M. Oyelere; writing-review and editing, all authors; visualization, Abisola M. Oyelere; supervision; Dieuwertje E. Kok, Fränzel J. B. van Duijnhoven, Ellen Kampman; project administration, Abisola M. Oyelere; funding acquisition, Dieuwertje E. Kok, Daniel Bos, Marc J. Gunter, Pietro Ferrari, Pekka Keski Rahkonen, Fränzel J. B. van Duijnhoven, Ellen Kampman. The work reported in this article has been performed by the authors, unless clearly specified in the text. All authors have read and approved the final version of the manuscript.
ACKNOWLEDGMENTS
The authors thank all participants in the COLON study, COLON investigators at Wageningen University & Research, and co-workers from the following hospitals for their effort in recruiting participants into the study: Hospital Gelderse Vallei, Ede; RadboudUMC, Nijmegen; Slingeland Hospital, Doetinchem; Canisius Wilhelmina Hospital, Nijmegen; Rijnstate Hospital, Arnhem; Gelre Hospitals, Apeldoorn/Zutphen; Hospital Bernhoven, Uden; Isala, Zwolle; ZGT, Almelo; Martini Hospital, Groningen; Admiraal de Ruyter Hospital, Goes/Vlissingen, all in the Netherlands. The authors thank the registration team of the Netherlands Comprehensive Cancer Organization (IKNL) for the collection of data for the Netherlands Cancer Registry.
FUNDING INFORMATION
The COLON study was financially supported by Wereld Kanker Onderzoek Fonds (WKOF) & World Cancer Research Fund International (WCRF International) as well as by funding (2014/1179, IIG_FULL_2021_022 and IIG_FULL_2021_023) obtained from the Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant program; Alpe d'HuZes/Dutch Cancer Society (UM 2012–5653, UW 2013–5927, UW 2015–7946); ERA-NET on Translational Cancer Research (TRANSCAN: Dutch Cancer Society (UW2013-6397, UW2014-6877), the Netherlands Organization for Health Research and Development (ZonMw), the Netherlands) and the Regio Deal Foodvalley (162135). The sponsors were not involved in the design, analysis, and interpretation of data in this study.
CONFLICT OF INTEREST STATEMENT
All authors declare no conflict of interest.
ETHICS STATEMENT
The COLON study (NCT0319110; ClinicalTrials.gov) was approved by an institutional review board (region Arnhem-Nijmegen, 2009–349) and all participants provided written informed consents.
DISCLAIMER
Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policies, or views of the International Agency for Research on Cancer/World Health Organization.
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