Reconciling the Epidemiology, Physiology, and Molecular Biology of Colon Cancer

Potter, John D.

doi:10.1001/jama.1992.03490120087033

Cited by 78 publications

(16 citation statements)

References 52 publications

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“…Notwithstanding the known limitations of our study, we consider that our results are meaningful and not the result of chance. One possible hypothesis might be that coffee reduces the concentration of 2 potential intestinal carcinogens in the bowel, namely bile acids and neutral sterol,37 which would appear consistent with the restriction of the association here to the colon 4, 35…”

Section: Discussionmentioning

confidence: 67%

“…Potential biological mechanisms may underlie the inverse association between coffee consumption and colon cancer observed here. These include a reduction in cholesterol, bile acid and neutral sterol secretion in the colon by substances in coffee, on the basis that bile acids are promoters of colon carcinogenesis 37. Coffee consumption may increase colonic motility, which may be inversely related to risk via the reduced epithelial exposure to colonic carcinogens,38 although this interpretation remains open to discussion 39.…”

Section: Discussionmentioning

confidence: 99%

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Coffee consumption and risk of colorectal cancer in a population‐based prospective cohort of Japanese men and women

Lee

Inoue

Otani³

et al. 2007

Intl Journal of Cancer

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We prospectively examined the association between coffee consumption and the risk of developing colorectal cancer in a large population-based cohort study (the JPHC Study) of Japanese men and women. Data were analyzed from a population-based cohort of 96,162 subjects (46,023 men and 50,139 women). A total of 1,163 incident colorectal cancers were identified during the followup period, including 763 cases of colon cancer and 400 of rectal cancer. We observed a significant inverse association between coffee consumption and the risk of developing invasive colon cancer among women. Compared with those who almost never consumed coffee, women who regularly consumed 3 or more cups of coffee per day had a RR of 0.44 (95% CI 5 0.19-1.04; p for trend 5 0.04) after adjustment for potential confounding factors. However, no significant association was found for rectal cancer in women. In men, no significant decrease was observed in any colorectal cancer site. Further, additional analyses on the association of green tea consumption with colorectal cancer risk found no significant association in men or women. These findings suggest that coffee consumption may lower the risk of colon cancer among Japanese women. ' 2007 Wiley-Liss, Inc.Key words: colorectal cancer; coffee; prospective study; Japan Colorectal cancer is one of the most common cancers in more developed countries, with nearly 945,000 new cases diagnosed worldwide each year and 492,000 deaths. 1 In Japan, the incidence and mortality of colorectal cancer has recently increased, and it is now a leading cause of morbidity and mortality, with about 36,000 deaths in 2000.2 This recent increase in Japan may be associated with changes in environmental factors such as dietary habits or lifestyle factors.Coffee drinking is popular in many parts of the world. In Japan, coffee has been popularly consumed since its initial introduction, although coffee consumption is relatively new in comparison to green tea consumption. Given the widespread consumption of coffee and high incidence of colorectal cancer in developed countries, the possible role of coffee consumption in the etiology of colorectal carcinogenesis has drawn interest, 3 and the relation between coffee consumption and colorectal cancer risk has been investigated over the last 4 decades. However, results from epidemiological studies have been inconsistent.3,4 A meta-analysis showed a lower risk of colorectal cancer associated with substantial consumption of coffee, 3 but the results were inconclusive owing to inconsistencies between case-control and prospective studies. Case-control studies have tended to support an inverse association between coffee consumption and risk of colorectal cancer, [5][6][7][8][9][10][11][12][13][14][15] whereas the albeit limited number of prospective cohort studies have not supported any significant reduction in risk. [16][17][18][19][20][21][22][23][24][25] Moreover, most previous studies have been conducted in Western countries. 16-24Here, we prospectively examined the association between...

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Coffee consumption and risk of colorectal cancer in a population‐based prospective cohort of Japanese men and women

Lee

Inoue

Otani³

et al. 2007

Intl Journal of Cancer

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“…34 Also, coffee consumption may reduce the synthesis and secretion of bile acids, which are known to be potential promoters of carcinogenesis. 35 Thus, these complex compounds in coffee with their various effects may explain the lack of association or the inconsistent results observed to date.…”

Section: Discussionmentioning

confidence: 99%

Coffee Consumption and Risk of Colorectal Cancer: The Japan Collaborative Cohort Study

Yamada

Kawado

Aoyama

et al. 2014

Journal of Epidemiology

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BackgroundEpidemiologic studies have reported coffee consumption to be associated with various health conditions. The purpose of this study was to examine the relationship of coffee consumption with colorectal cancer incidence in a large-scale prospective cohort study in Japan.MethodsWe used data from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). Here, we analyzed a total of 58 221 persons (23 607 men, 34 614 women) followed from 1988 to the end of 2009. During 738 669 person-years of follow-up for the analysis of colorectal cancer risk with coffee consumption at baseline, we identified 687 cases of colon cancer (355 males and 332 females) and 314 cases of rectal cancer (202 males and 112 females). We used the Cox proportional-hazard regression model to estimate hazard ratio (HR).ResultsCompared to those who consumed less than 1 cup of coffee per day, men who consumed 2–3 cups of coffee per day had an HR of 1.26 (95% confidence interval [CI] 0.93–1.70), and men who consumed more than 4 cups of coffee per day had an HR of 1.79 (95% CI 1.01–3.18). A statistically significant increase in the risk of colon cancer was associated with increasing coffee consumption among men (P for trend = 0.03). On the other hand, coffee consumption in women was not associated with incident risk of colon cancer. Coffee consumption was also not associated with rectal cancer incidence in men or women.ConclusionsThis large-scale population-based cohort study showed that coffee consumption increases the risk of colon cancer among Japanese men.

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“…While we cannot rule out the possibility that uncontrolled confounding or bias accounts for the marginally lower risk of colorectal cancer among high coffee consumers, some possible mechanisms have been suggested. The potential protection of coffee against colorectal cancer may be explained in terms of antimutagenic properties of some coffee compounds ( e.g ., insoluble hemicellulose fiber, high molecular‐weight polyphenol)42; antioxidant properties of several phenolic compounds found in coffee beans ( e.g ., chlorogenic acid, caffeic acid,) partly lost during roasting43, 44; reductions of bile acid (a promoter of colon cancer) secretions into the colon45 and synthesis by down‐regulating the expression of the bile acid homeostatic genes,46 and the elimination of several carcinogens by the coffee diterpenes cafestol and kahweol47; and an increase in colonic motility limited to the rectosigmoid region by both regular and decaffeinated coffee, seen predominantly in women 26. In addition, coffee intake might also decrease colon cancer risk by reducing the risk of Type 2 diabetes, which is a known risk factor for colorectal cancer 48, 49.…”

Section: Discussionmentioning

confidence: 99%

Coffee consumption and risk of colorectal cancer: A systematic review and meta‐analysis of prospective cohort studies

Liu

Giovannucci

2009

Intl Journal of Cancer

105

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An inverse association between coffee consumption and the risk of colorectal cancer has been found in several case-control studies, but such an association was not consistent in prospective cohort studies. We conducted a systematic meta-analysis of prospective cohort studies on coffee consumption and colorectal cancer published up to June 2008. We combined relative risks (RR) for colorectal cancer comparing high vs. low categories of coffee consumption using random-effects models. We identified 12 eligible cohort studies, which included 646,848 participants and 5,403 cases for colorectal cancer. The summarized result of the meta-analysis comparing high-vs. low-consumption categories showed no significant effect of coffee consumption on colorectal cancer risk (RR 5 0.91; 95% confidence intervals [CI]: 0.81-1.02). The RR was 0.93 (95% CI: 0.71-1.22) when considering 4 studies conducted in the United States of America, 0.91 (95% CI: 0.76-1.10) for 5 studies from Europe, and 0.83 (95% CI: 0.62-1.10) for 3 Japanese studies. No significant differences by sex and cancer-site were found, but there was a slight suggestion of an inverse association between coffee consumption and colon cancer in women (RR 5 0.79; 95% CI: 0.60-1.04), especially Japanese women (RR 5 0.62; 95% CI: 0.37-1.05). The suggestive inverse associations were slightly stronger in studies that controlled for smoking and alcohol, and in studies with shorter follow-up times. Information on coffee type, its serving size, or brewing method may provide a better understanding of this reassuring result and the real role of coffee on colorectal cancer risk. ' 2008 Wiley-Liss, Inc.Key words: caffeine; coffee; colorectal neoplasms; meta-analysis; prospective studies Colorectal cancer is the third most common cancer worldwide. 1 Although obesity, smoking, alcohol, and physical inactivity are important risk factors for colorectal cancer, nutritional factors are also considered to play an important role for its development. 2 The relationship between coffee consumption and colorectal cancer risk has been extensively examined over the last 4 decades. 3 Coffee is a complex mixture of more than a thousand chemicals, and these constituents have potential genotoxic and mutagenic properties, but also antioxidant and antimutagenic activities, 4,5 any of which could affect colorectal cancer risk. Several case-control studies have shown an inverse association between coffee consumption and risk of colorectal cancer. A meta-analysis, combining the results of 12 case-control studies, found an odds ratio of 0.72 (95% confidence interval [CI]: 0.61-0.84) for high vs. low coffee intake, but the combination of 5 cohort studies demonstrated no association (relative risk [RR] 5 0.97; 95% CI: 0.73-1.29). 6 Although the data from case-control studies are relatively consistent, they may be subject to recall bias with respect to coffee consumption and selection bias with respect to the control group. Additional prospective cohort studies excluding those biases would be more useful to s...

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Reconciling the Epidemiology, Physiology, and Molecular Biology of Colon Cancer

Cited by 78 publications

References 52 publications

Coffee consumption and risk of colorectal cancer in a population‐based prospective cohort of Japanese men and women

Coffee consumption and risk of colorectal cancer in a population‐based prospective cohort of Japanese men and women

Coffee Consumption and Risk of Colorectal Cancer: The Japan Collaborative Cohort Study

Coffee consumption and risk of colorectal cancer: A systematic review and meta‐analysis of prospective cohort studies

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