Person:

Mackintosh, Christopher

Previous studies have identified associations between dietary and lifestyle factors and the incidence, risk of recurrence, and mortality of colorectal cancer. The consumption of coffee is one such factor that has been positively associated with improved prognosis in colorectal cancer patients, a finding that has been supported by both epidemiological and laboratory-based in vivo and in vitro studies. Using data collected as part of a national phase

III randomized clinical trial (CALGB/SWOG 80405), we conducted a prospective epidemiological study of the effects of coffee consumption on survival in metastatic colorectal cancer patients. To our knowledge, this is the first study to examine the prognostic impact of coffee consumption in patients with metastatic colorectal cancer. Among this cohort of patients, we detected a significant inverse association between the increasing consumption of coffee and a decreased hazard of both cancer progression and death from any cause. Participants who consumed 4 or more cups of coffee per day had an adjusted hazard ratio for overall mortality of 0.62 (95% CI, 0.43 to 0.89; Ptrend = 0.008) and an adjusted hazard ratio for disease progression or death of 0.71 (95% CI, 0.52 to 0.98; Ptrend = 0.04). These findings were consistent across strata of demographic, clinical, and disease characteristics, and a significant interaction was noted between coffee consumption and adherence to a healthy ‘prudent’ dietary pattern (Pinteraction = 0.01). Our results suggest a role for coffee consumption in the prognosis of patients with colorectal cancer, possibly mediated by its anti-oxidant and anti-inflammatory properties, or effects on insulin-sensitizing pathways. Further research is warranted to fully characterize these possible underlying mechanisms.