Plain language summary
The most investigated risk factors for Hepatocellular carcinoma (HCC) (Liver cancer) are alcohol, diet and obesity. This cohort study looks at tea and coffee (caffeinated and decaffeinated) consumption with HCC risk using data from the European Prospective Investigation into Cancer and nutrition study (EPIC). The EPIC study recruited 521,000 apparently healthy participants, aged 25-70 years, from 10 European countries between 1992 and 2000. Their diets were assessed by questionnaire alongside biometric data and other lifestyle factors. The researchers were able to identify 201 HCC cases among 486,799 men/women, after a median follow-up of 11 years. Some data had to be excluded based on cultural tea and coffee drinking habits (particularly lack of data from certain nationalities). There was coffee data from 163,672 participants drinking an overall median of 354 ml/d among men and 290 ml/d among women. The results found that increased coffee intake in participants in the highest compared to the lowest quintile had a lower HCC risk by 72%. There was no significant data for decaffeinated coffee. Tea drinkers represented just 66% of the total cohort and median intakes were 107 ml/d for men and 190 ml/d for women. Tea intake was also inversely associated with HCC incidence with 60% lower HCC risk. The study concludes that intakes of coffee and, to a lesser extent, tea are associated with lower HCC incidence. The incidence of HCC in participants was low so further studies are necessary.
Abstract
Inverse associations of coffee and/or tea in relation to hepatocellular carcinoma (HCC) risk have been consistently identified in studies conducted mostly in Asia where consumption patterns of such beverages differ from Europe. In the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 201 HCC cases among 486,799 men/women, after a median follow-up of 11 years. We calculated adjusted hazard ratios (HRs) for HCC incidence in relation to quintiles/categories of coffee/tea intakes. We found that increased coffee and tea intakes were consistently associated with lower HCC risk. The inverse associations were substantial, monotonic and statistically significant. Coffee consumers in the highest compared to the lowest quintile had lower HCC risk by 72% [HR: 0.28; 95% confidence intervals (CIs): 0.16-0.50, p-trend < 0.001]. The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22-0.78, p-trend = 0.003). There was no compelling evidence of heterogeneity of these associations across strata of important HCC risk factors, including hepatitis B or hepatitis C status (available in a nested case-control study). The inverse, monotonic associations of coffee intake with HCC were apparent for caffeinated (p-trend = 0.009), but not decaffeinated (p-trend = 0.45) coffee for which, however, data were available for a fraction of subjects. Results from this multicentre, European cohort study strengthen the existing evidence regarding the inverse association between coffee/tea and HCC risk. Given the apparent lack of heterogeneity of these associations by HCC risk factors and that coffee/tea are universal exposures, our results could have important implications for high HCC risk subjects.
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