Xia Jiadong, Chen Jie, Xue Jian-Xin, Yang Jie, Wang Zeng-Jun
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China.
Urol J. 2017 Aug 29;14(5):4079-4088.
Results of the association between coffee consumption (CC) and the risk of prostate cancer (PC) are still controversy. Based on published relevant studies, we conducted an up-to-date meta-analysis to investigatethis issue.
The protocol used in this article is in accordance with the PRISMA checklist. Eligible studies were screened and retrieved by using PUBMED and EMBASE as well as manual review of references up to July 2016. We calculated the pooled relative risk (RR) with 95% confidence interval (CI) with random effect models. The dose-response relationship was assessed by generalized least-squares trend estimation analysis.
Totally, we included twenty-eight studies (14 case-control and 14 cohort studies) on CC with 42399 PC patients for the final meta-analysis. No significant association of PC was found for high versus non/lowestCC, with RR = 1.07 (95% CI: 0.96-1.18). In subgroup meta-analysis by study design, there were no significant positive associations between CC and PC in case-control studies (RR = 1.19, 95% CI: 1.05-1.35) or in the cohort studies (RR = 0.97, 95% CI: 0.84-1.12). Additionally, RR with different quality of studies were respectively 1.15 (95% CI: 0.99-1.34) and 1.28 (95% CI: 1.03-1.58) for high and low quality in the case-control studies; while were respectively 1.02 (95% CI: 0.88-1.20) and 0.81 (95% CI: 0.57-1.14) in the cohort studies. When analyzed by geographic area, we found no association between CC and PC, with RR = 1.06 (95% CI: 0.86-1.30) for 10 studies from Europe, 1.06 (95% CI: 0.94-1.20) for 13 studies conducted in America; 1.12 (95% CI: 0.70-1.79) for 4 studiesfrom Asia. However, in subgroup analysis by subtype of the disease, there was a significant negative (beneficial) association in the localized PC (RR = 0.90, 95% CI: 0.84-0.97), but not for the advanced PC (RR = 0.90, 95%CI: 0.70-1.16). Additionally, RR = 0.99 (95% CI: 0.98-0.99) for an increment of one cup per day of coffee intake shows significant association with the localized PC.
Our results indicate that CC has no harmful effect on PC. On the contrary, it has an effect on reducing the localized PC risk. Further prospective cohort studies of high quality are required to clarify this relationship.
咖啡消费（CC）与前列腺癌（PC）风险之间的关联结果仍存在争议。基于已发表的相关研究，我们进行了一项最新的荟萃分析来研究这个问题。
本文使用的方案符合PRISMA清单。通过使用PUBMED和EMBASE以及截至2016年7月的参考文献人工检索筛选符合条件的研究。我们使用随机效应模型计算合并相对风险（RR）及95%置信区间（CI）。通过广义最小二乘趋势估计分析评估剂量反应关系。
最终的荟萃分析共纳入了28项关于CC的研究（14项病例对照研究和14项队列研究），涉及42399例PC患者。未发现高咖啡消费与非/最低咖啡消费相比PC有显著关联，RR = 1.07（95%CI：0.96 - 1.18）。在按研究设计进行的亚组荟萃分析中，病例对照研究（RR = 1.19，95%CI：1.05 - 1.35）或队列研究（RR = 0.97，95%CI：0.84 - 1.12）中CC与PC之间均无显著正相关。此外，病例对照研究中高质量和低质量研究的RR分别为1.15（95%CI：0.99 - 1.34）和1.28（95%CI：1.03 - 1.58）；队列研究中分别为1.02（95%CI：0.88 - 1.20）和0.81（95%CI：0.57 - 1.14）。按地理区域分析时，我们发现CC与PC之间无关联，欧洲的10项研究RR = 1.06（95%CI：0.86 - 1.30），美国进行的13项研究RR = 1.06（95%CI：0.94 - 1.20）；亚洲的4项研究RR = 1.12（95%CI：0.70 - 1.79）。然而，在按疾病亚型进行的亚组分析中，局限性PC存在显著负（有益）关联（RR = 0.90，95%CI：0.84 - 0.97），但晚期PC无此关联（RR = 0.90，95%CI：0.70 - 1.16）。此外，每天咖啡摄入量增加一杯的RR = 0.99（95%CI：0.98 - 0.99）显示与局限性PC有显著关联。
我们的结果表明CC对PC没有有害影响。相反，它对降低局限性PC风险有作用。需要进一步开展高质量的前瞻性队列研究来阐明这种关系。
