Coffee, Tea and Decaffeinated Coffee in Relation To
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Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: Multicentre, prospective cohort study Christina Bamia, University of Athens Pagona Lagiou, University of Athens Mazda Jenab, International Agency for Research on Cancer Antonia Trichopoulou, University of Athens Veronika Fedirko, Emory University Krasimira Aleksandrova, German Institute of Human Nutrition Potsdam-Rehbrücke Tobias Pischon, German Institute of Human Nutrition Potsdam-Rehbrücke Kim Overvad, Aarhus University Anja Olsen, Danish Cancer Society Research Center Anne Tjonneland, Danish Cancer Society Research Center Only first 10 authors above; see publication for full author list. Journal Title: International Journal of Cancer Volume: Volume 136, Number 8 Publisher: Wiley: 12 months | 2015-04-15, Pages 1899-1908 Type of Work: Article | Post-print: After Peer Review Publisher DOI: 10.1002/ijc.29214 Permanent URL: https://pid.emory.edu/ark:/25593/tm57j Final published version: http://dx.doi.org/10.1002/ijc.29214 Copyright information: © 2014 UICC. Accessed October 2, 2021 1:58 PM EDT Europe PMC Funders Group Author Manuscript Int J Cancer. Author manuscript; available in PMC 2018 December 07. Published in final edited form as: Int J Cancer. 2015 April 15; 136(8): 1899–1908. doi:10.1002/ijc.29214. Europe PMC Funders Author Manuscripts Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: multi-centre, prospective cohort study Christina Bamia1, Pagona Lagiou1,2,3, Mazda Jenab4, Antonia Trichopoulou1,5, Veronika Fedirko4,6, Krasimira Aleksandrova7, Tobias Pischon7,8, Kim Overvad9, Anja Olsen10, Anne TjØnneland10, Marie-Christine Boutron-ruault11,12,13, Guy Fagherazzi11,12,13, Antoine Racine11,12,13, Tilman Kuhn14, Heiner Boeing7, Anna Floegel7, Vasiliki Benetou1,5, Domenico Palli15, Sara Grioni16, Salvatore Panico17, Rosario Tumino18, Paolo Vineis19,20, H.B(as) Bueno-de-mesquita20,21,22, Vincent K. Dik22, Nirmala Bhoo-Pathy23,24, Cuno SPM Uiterwaal23, Elisabete Weiderpass25,26,27,28, Eiliv Lund25, J.Ramón Quirós29, Raul Zamora- ros4,30, Esther Molina-Montes31,32,33, Maria-Dolores Chirlaque33,34, Eva Ardanaz33,35, Miren Dorronsoro36,37, Björn Lindkvist38, Peter Wallström39, Lena Maria Nilsson40,41, Malin Sund42, Kay-Tee Khaw43, Nick Wareham43,44, Kathryn E Bradbury45, Ruth C Travis45, Pietro Ferrari4, Talita Duarte-salles4, Magdalena Stepien4, Marc Gunter20, Neil Murphy20, Elio Riboli20, and Dimitrios Trichopoulos2,3,5 1Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 115 27 Athens, Greece 2Bureau of Epidemiologic Research, Academy of Athens, 115 27 Europe PMC Funders Author Manuscripts Athens, Greece 3Department of Epidemiology, Harvard School of Public Health, MA, 02115 Boston, USA 4International Agency for Research on Cancer (IARC-WHO), 69372 Lyon, France 5Hellenic Health Foundation, 115 27, Athens, Greece 6Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, 30322, Atlanta GA, USA 7Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany 8Molecular Epidemiology Group, Max Delbrück Center for Molecular Medicine (MDC) Berlin-Buch, D-13125 Berlin, Germany 9Department of Epidemiology, School of Public Health, Aarhus University, DK-8000 Aarhus, Denmark 10Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark 11Inserm, Centre for Research in Epidemiology and Population Health, U1018, Institut Gustave Roussy, F-94805, Villejuif, Paris, France 12Paris South University, UMRS 1018, F-94805, Villejuif, Paris, France 13IGR, F-94805, Villejuif, Paris, France 14 German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany 15Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, 50139 Florence, Italy 16Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy 17Department of clinical and experimental medicine, Federico II University, 80131 Naples, Italy 18Cancer Registry and Histopathology Unit, "Civic - M.P.Arezzo" Hospital, ASP Corresponding Author: Dr. Christina Bamia, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, 75 Mikras Asias st. 115 27 Goudi, Athens, Greece, Phone: +30 210 7462096, Fax: +30 210 7462079, [email protected]. Conflict of interest The authors declared no conflict of interest. Bamia et al. Page 2 97100 Ragusa, Italy 19HuGeF - Human Genetics Foundation, 10126 Torino, Italy 20Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY London, UK 21National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands 22Department of Gastroenterology and Hepatology, University Europe PMC Funders Author Manuscripts Medical Centre Utrecht, 3508 GA Utrecht, The Netherlands 23Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA, Utrecht, The Netherlands 24Julius Centre, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia 25Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway 26Department of Research, Cancer Registry of Norway, NO-0304 Oslo, Norway 27Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE - 17177 Stockholm, Sweden 28Samfundet Folkhälsan, Helsinki, 00250 Finland 29Public Health Directorate, CP 33006 Asturias, Spain 30Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08907 Barcelona, Spain 31Andalusian School of Public Health, 18080 Granada, Spain 32Instituto de Investigación Biosanitario de Granada (Granada.bs), 18001 Granada, Spain 33CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain 34Epidemiology Department, Murcia Regional Health Council, 30008 Murcia, Spain 35Navarre Public Health Institute, 31003 Pamplona, Spain 36Public Health Direction, Basque Regional Health Department, 4-20013 Donostia, San Sebastian, Spain 37 Biodonostia Research Institute CIBER Epidemiology and Public Health CIBERESP, s/n 20014 San Sebastian, Spain 38Institute of Medicine, Sahlgrenska Academy, University of Gothenburg SE-40530 Gothenburg, Sweden 39Nutrition Epidemiology Research Group, Dept. of Clinical Sciences, Lund University, SE-20502 Malmö, Sweden 40Public health and clinical medicine, Nutritional research, Umeå University, SE-90185 Umeå, Sweden 41Arcum, Arctic Research Centre at Umeå University, SE-90185 Umeå, Sweden 42Experimental Europe PMC Funders Author Manuscripts Surgery, Department of Surgical and Perioperative Sciences/Surgery, Umea University, SE-90185 Umea, Sweden 43University of Cambridge, CB2 0SR Cambridge, UK 44MRC Epidemiology Unit, CB2 0QQ Cambridge, UK 45Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK 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 (HR) 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 (CI): 0,16 to 0.50, P-trend <0.001). The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22 to 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 Int J Cancer. Author manuscript; available in PMC 2018 December 07. Bamia et al. Page 3 apparent for caffeinated (P-rend=0.009), but not decaffeinated (P-trend=0.45) coffee for which, however, data were available for a fraction of subjects. Results from this multi-centre, 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 Europe PMC Funders Author Manuscripts HCC risk subjects. Keywords Hepatocellular carcinoma; liver cancer; coffee; tea; EPIC Introduction Hepatocellular carcinoma (HCC) accounts for 85-95% of primary liver cancer cases.1 Several risk factors have been identified, but with respect to diet only alcohol, obesity2 and anatoxin3 have been documented. The role of other dietary exposures is still under investigation.4 Since 2000, the association of coffee and tea consumption with HCC risk has been investigated in case-control and cohort studies conducted mostly in Asia, where exposure patterns to these beverages differ compared to western countries; two cohort studies on coffee