Michels Karin B, Willett Walter C, Fuchs Charles S, Giovannucci Edward
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, and Harvard Medical School, 221 Longwood Ave., Boston, MA 02115, USA.
J Natl Cancer Inst. 2005 Feb 16;97(4):282-92. doi: 10.1093/jnci/dji039.
Frequent coffee consumption has been associated with a reduced risk of colorectal cancer in a number of case-control studies. Cohort studies have not revealed such an association but were limited in size. We explored the association between consumption of coffee and tea and the incidence of colorectal cancer in two large prospective cohorts of women and men.
We used data from the Nurses' Health Study (women) and the Health Professionals' Follow-up Study (men). Consumption of coffee and tea and total caffeine intake were assessed and updated in 1980, 1984, 1986, 1990, and 1994 among women and in 1986, 1990, and 1994 among men. The incidence of cancer of the colon or rectum was ascertained through 1998. Hazard ratios were calculated using Cox proportional hazards models that adjusted for potential confounders. All tests of statistical significance were two-sided.
During almost 2 million person-years of follow-up, 1438 cases of colorectal cancer were observed. Consumption of caffeinated coffee or tea with caffeine or caffeine intake was not associated with the incidence of colon or rectal cancer in either cohort. For both cohorts combined, the covariate-adjusted hazard ratio for colorectal cancer associated with consumption of each additional cup of caffeinated coffee was 0.99 (95% confidence interval [CI] = 0.96 to 1.03). However, participants who regularly consumed two or more cups of decaffeinated coffee per day had a 52% (95% CI = 19% to 71%) lower incidence of rectal cancer than those who never consumed decaffeinated coffee.
Consumption of caffeinated coffee, tea with caffeine, or caffeine was not associated with incidence of colon of rectal cancer, whereas regular consumption of decaffeinated coffee was associated with a reduced incidence of rectal cancer.
在多项病例对照研究中,经常饮用咖啡与降低结直肠癌风险相关。队列研究尚未揭示这种关联,但规模有限。我们在两个大型的男性和女性前瞻性队列中探讨了咖啡和茶的消费与结直肠癌发病率之间的关联。
我们使用了护士健康研究(女性)和卫生专业人员随访研究(男性)的数据。在1980年、1984年、1986年、1990年和1994年对女性以及1986年、1990年和1994年对男性评估并更新了咖啡、茶的消费量以及总咖啡因摄入量。通过1998年确定结肠或直肠癌的发病率。使用调整了潜在混杂因素的Cox比例风险模型计算风险比。所有统计学显著性检验均为双侧检验。
在近200万人年的随访期间,观察到1438例结直肠癌病例。饮用含咖啡因的咖啡或茶、摄入咖啡因与两个队列中结肠或直肠癌的发病率均无关联。对于两个队列合并分析,每多饮用一杯含咖啡因咖啡相关的结直肠癌协变量调整风险比为0.99(95%置信区间[CI]=0.96至1.03)。然而,每天定期饮用两杯或更多杯脱咖啡因咖啡的参与者患直肠癌的发病率比从不饮用脱咖啡因咖啡的参与者低52%(95%CI=19%至71%)。
饮用含咖啡因的咖啡、含咖啡因的茶或摄入咖啡因与结肠癌或直肠癌的发病率无关,而经常饮用脱咖啡因咖啡与降低直肠癌发病率相关。