Royal Free London NHS Foundation Trust, London, NW3 2QG, United Kingdom.
Cancer Epidemiology Unit, Nuffield Department of Population Health, Oxford, OX3 7LF, United Kingdom.
Int J Cancer. 2019 Sep 15;145(6):1484-1492. doi: 10.1002/ijc.31994. Epub 2018 Dec 28.
Reported associations between coffee consumption and an increased risk of pancreatic cancer could be due to residual confounding by smoking and/or biased recall of coffee consumption in retrospective studies. Studying associations prospectively in never smokers should minimize these problems, but thus far such studies have included relatively small numbers of cases. In our study, 309,797 never-smoking women self-reported typical daily coffee consumption at a mean age of 59.5 years (SD 5.0 years) and were followed up for a median of 13.7 years (IQR: 12.2-14.9) through record linkage to national health cancer and death registries. During this period, 962 incident cases of pancreatic cancers were registered. Cox regression was used to calculate adjusted relative risks [RRs] of incident pancreatic cancer with 95% confidence intervals [CIs] in relation to coffee consumption at baseline. After adjustment for potential confounding factors, including body mass index and alcohol consumption, RRs of pancreatic cancer in never-smokers who reported usually consuming 1-2, 3-4, and ≥ 5 cups of coffee daily, compared to nondrinkers of coffee, were 1.02 (CI 0.83-1.26), 0.96 (0.76-1.22), and 0.87 (0.64-1.18), respectively (trend p = 0.2). A meta-analysis of results from this cohort and 3 smaller prospective studies found little or no statistically significant association between coffee consumption and pancreatic cancer risk in never smokers (summary RR = 1.00, CI 0.86-1.17 for ≥2 vs. zero cups of coffee per day).
报告称，喝咖啡与胰腺癌风险增加之间存在关联，这可能是由于吸烟引起的残余混杂因素和/或在回顾性研究中对咖啡摄入量的偏倚回忆。在从不吸烟的人群中进行前瞻性研究应该可以最小化这些问题，但到目前为止，此类研究纳入的病例相对较少。在我们的研究中，309797 名从不吸烟的女性在平均年龄为 59.5 岁（SD 5.0 岁）时自我报告了典型的每日咖啡摄入量，并通过与国家健康癌症和死亡登记处的记录链接进行了中位 13.7 年（IQR：12.2-14.9）的随访。在此期间，登记了 962 例胰腺癌新发病例。使用 Cox 回归计算了与基线时咖啡摄入量相关的调整后相对风险 [RR] [95%置信区间 [CI]]。在校正了潜在的混杂因素（包括体重指数和饮酒量）后，与不喝咖啡的人相比，报告每天通常饮用 1-2 杯、3-4 杯和≥5 杯咖啡的从不吸烟者患胰腺癌的 RR 分别为 1.02（CI 0.83-1.26）、0.96（0.76-1.22）和 0.87（0.64-1.18）（趋势 p = 0.2）。对该队列和 3 项较小的前瞻性研究的结果进行的荟萃分析发现，从不吸烟者中咖啡摄入量与胰腺癌风险之间几乎没有或没有统计学上显著的关联（汇总 RR = 1.00，CI 0.86-1.17，每天≥2 杯与零杯相比）。
