Galarraga Vania, Boffetta Paolo
Icahn School of Medicine at Mount Sinai, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2016 Jun;25(6):951-7. doi: 10.1158/1055-9965.EPI-15-0727. Epub 2016 Mar 28.
Previous epidemiologic results on coffee consumption and lung cancer risk have not been consistent. Furthermore, not all studies have addressed the potential role of tobacco as a confounder in this association. A meta-analysis was conducted to assess the effect of coffee consumption on lung cancer risk independent of tobacco use.
A systematic review and a meta-analysis based on random effects models were performed using studies from the PubMed and EMBASE databases, and the references from the retrieved articles. Included were 8 prospective cohorts and 13 case-control studies, which provided data for 19,892 cases and 623,645 non-cases, timeframe 1986-2015.
The meta-relative risk (RR) for coffee drinking, not controlling for tobacco smoking, was 1.09 [95% confidence interval (CI), 1.00-1.19], the reference group was never drinkers. There was significant heterogeneity among the study results (Q = 84.39, I² = 75.1%, Pheterogeneity < 0.001). Among non-smokers, coffee was not associated with lung cancer risk (RR, 0.92; 95% CI, 0.75-1.10), the reference group was never drinkers. The meta-RR for 1 cup per day increase, unadjusted for smoking, was 1.04 (95% CI, 1.03-1.05); the corresponding RR for non-smokers was 0.95 (95% CI, 0.83-1.09).
The pooled estimates indicated that when the potential confounding effect from smoking is controlled for, coffee drinking does not appear to be a lung cancer risk factor. Further pooled analyses, with larger non-smokers population size, are encouraged to confirm these results.
This study illustrates that the association between coffee consumption and lung cancer can be confounded by tobacco smoking. Cancer Epidemiol Biomarkers Prev; 25(6); 951-7. ©2016 AACR.
既往关于咖啡饮用与肺癌风险关系的流行病学研究结果并不一致。此外，并非所有研究都探讨了烟草在这种关联中作为混杂因素的潜在作用。开展了一项荟萃分析，以评估在不考虑烟草使用的情况下咖啡饮用对肺癌风险的影响。
基于随机效应模型进行了一项系统评价和荟萃分析，使用了来自PubMed和EMBASE数据库的研究以及检索文章的参考文献。纳入了8项前瞻性队列研究和13项病例对照研究，这些研究提供了19892例病例和623645例非病例的数据，时间范围为1986 - 2015年。
未对吸烟进行控制时，咖啡饮用的荟萃相对风险（RR）为1.09 [95%置信区间（CI），1.00 - 1.19]，参照组为从不饮用者。研究结果之间存在显著异质性（Q = 84.39，I² = 75.1%，异质性P < 0.001）。在不吸烟者中，咖啡与肺癌风险无关（RR，0.92；95% CI，0.75 - 1.10），参照组为从不饮用者。每天增加1杯咖啡且未对吸烟进行校正时的荟萃RR为1.04（95% CI，1.03 - 1.05）；不吸烟者的相应RR为0.95（95% CI，0.83 - 1.09）。
汇总估计表明，当控制吸烟的潜在混杂效应时，咖啡饮用似乎不是肺癌的危险因素。鼓励进行更大规模不吸烟者群体的进一步汇总分析以证实这些结果。
本研究表明，咖啡饮用与肺癌之间的关联可能会受到吸烟的混杂影响。《癌症流行病学、生物标志物与预防》；25(6)；951 - 7。©2016美国癌症研究协会。
