Rosenberg L, Werler M M, Palmer J R, Kaufman D W, Warshauer M E, Stolley P D, Shapiro S
Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA 02146.
Am J Epidemiol. 1989 Nov;130(5):895-903. doi: 10.1093/oxfordjournals.aje.a115422.
To assess whether recent coffee consumption is related to the incidence of large bowel cancer, the authors analyzed data from a multipurpose hospital-based case-control study of several cancers, conducted from 1978 to 1986 in Boston, Massachusetts, New York, New York, Philadelphia, Pennsylvania, and Baltimore, Maryland: 717 cases of colon cancer and 538 cases of rectal cancer were compared with 3,883 controls admitted for nonmalignant and malignant illnesses unrelated to coffee use. Relative risks were estimated by multiple logistic regression with allowance for age, sex, cigarette smoking, alcohol consumption, and several other potential confounding factors. Overall, relative to the consumption of one cup of coffee per day, the estimated relative risk of colon cancer for consumption of up to four cups per day in the period before admission was close to 1.0; for consumption of five or more cups per day, it was 0.6 (95% confidence interval 0.4-0.8). The results were consistent in men and women, and similar results were obtained whether the measure of consumption was use in the year before admission or use three years before admission. For rectal cancer, some relative risk estimates were elevated, particularly in men, but there was no consistent pattern of association, nor was there a trend of increasing risk with increasing consumption. The data suggest that recent coffee consumption is not related to an increased risks of large bowel cancer and that heavy coffee consumption may reduce the risk of colon cancer. A biologic rationale for such a reduction has not been established.
为评估近期咖啡摄入量是否与大肠癌发病率相关，作者分析了1978年至1986年在马萨诸塞州波士顿、纽约州纽约市、宾夕法尼亚州费城和马里兰州巴尔的摩开展的一项针对多种癌症的以综合医院为基础的病例对照研究的数据：将717例结肠癌病例和538例直肠癌病例与3883名因非恶性和与咖啡使用无关的恶性疾病入院的对照者进行比较。通过多因素logistic回归估计相对风险，并对年龄、性别、吸烟、饮酒及其他几个潜在混杂因素进行校正。总体而言，相对于每天饮用一杯咖啡，入院前每天饮用多达四杯咖啡的结肠癌估计相对风险接近1.0；每天饮用五杯或更多杯咖啡时，相对风险为0.6（95%置信区间0.4 - 0.8）。男性和女性的结果一致，无论摄入量的衡量标准是入院前一年的饮用情况还是入院前三年的饮用情况，都得到了类似结果。对于直肠癌，一些相对风险估计值有所升高，尤其是在男性中，但没有一致的关联模式，也没有随着摄入量增加风险上升的趋势。数据表明，近期咖啡摄入量与大肠癌风险增加无关，大量饮用咖啡可能会降低结肠癌风险。尚未确定这种降低风险的生物学原理。
