State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Section of Nutrition and Metabolism, International Agency for Research on Cancer, 150, cours Albert Thomas F-69372, Cedex 08, Lyon, France.
BMC Cancer. 2020 Feb 5;20(1):101. doi: 10.1186/s12885-020-6561-9.
Epidemiological studies on the association between coffee intake and cancer risk have yielded inconsistent results. To summarize and appraise the quality of the current evidence, we conducted an umbrella review of existing findings from meta-analyses of observational studies.
We searched PubMed, Embase, Web of Science and the Cochrane database to obtain systematic reviews and meta-analyses of associations between coffee intake and cancer incidence. For each association, we estimated the summary effect size using the fixed- and random-effects model, the 95% confidence interval, and the 95% prediction interval. We also assessed heterogeneity, evidence of small-study effects, and excess significance bias.
Twenty-eight individual meta-analyses including 36 summary associations for 26 cancer sites were retrieved for this umbrella review. A total of 17 meta-analyses were significant at P ≤ 0.05 in the random-effects model. For the highest versus lowest categories, 4 of 26 associations had a more stringent P value (P ≤ 10). Associations for five cancers were significant in dose-response analyses. Most studies (69%) showed low heterogeneity (I ≤ 50%). Three and six associations had evidence of excessive significance bias and publication bias, respectively. Coffee intake was inversely related to the risk of liver cancer and endometrial cancer and was characterized by dose-response relationships. There were no substantial changes when we restricted analyses to meta-analysis of cohort studies.
There is highly suggestive evidence for an inverse association between coffee intake and risk of liver and endometrial cancer. Further research is needed to provide more robust evidence for cancer at other sites.
关于咖啡摄入量与癌症风险之间关联的流行病学研究结果不一致。为了总结和评估现有证据的质量，我们对观察性研究的荟萃分析进行了伞式评价。
我们检索了 PubMed、Embase、Web of Science 和 Cochrane 数据库，以获取关于咖啡摄入量与癌症发病率之间关联的系统评价和荟萃分析。对于每个关联，我们使用固定效应和随机效应模型、95%置信区间和 95%预测区间来估计汇总效应大小。我们还评估了异质性、小样本效应的证据和过度显著偏差。
本伞式评价共检索到 28 项个体荟萃分析，涉及 26 个癌症部位的 36 个汇总关联。共有 17 项荟萃分析在随机效应模型中 P 值≤0.05 时具有统计学意义。对于最高与最低类别，26 个关联中有 4 个具有更严格的 P 值（P≤10）。在剂量反应分析中，有 5 种癌症的关联具有统计学意义。大多数研究（69%）显示低异质性（I≤50%）。有 3 项和 6 项关联分别存在过度显著偏差和发表偏倚的证据。咖啡摄入量与肝癌和子宫内膜癌风险呈负相关，并具有剂量反应关系。当我们将分析仅限于队列研究的荟萃分析时，没有实质性变化。
有高度提示性证据表明，咖啡摄入量与肝癌和子宫内膜癌风险呈负相关。需要进一步研究为其他部位的癌症提供更有力的证据。
