Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis
Objectives To examine the association between coffee, including caffeinated and decaffeinated coffee, with hepatocellular carcinoma (HCC) and assess the influence of HCC aetiology and pre-existing liver disease.Design We performed a systematic review and meta-analysis. We calculated relative risks (...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2017-05-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/7/5/e013739.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823862486667886592 |
|---|---|
| author | Paul Roderick Peter Clive Hayes Julie Parkes Ryan Buchanan Oliver John Kennedy Jonathan Andrew Fallowfield |
| author_facet | Paul Roderick Peter Clive Hayes Julie Parkes Ryan Buchanan Oliver John Kennedy Jonathan Andrew Fallowfield |
| author_sort | Paul Roderick |
| collection | DOAJ |
| description | Objectives To examine the association between coffee, including caffeinated and decaffeinated coffee, with hepatocellular carcinoma (HCC) and assess the influence of HCC aetiology and pre-existing liver disease.Design We performed a systematic review and meta-analysis. We calculated relative risks (RRs) of HCC according to caffeinated and decaffeinated coffee consumption using a random-effects dose–response meta-analysis. We tested for modification of the effect estimate by HCC aetiology and pre-existing liver disease. We judged the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.Results We found 18 cohorts, involving 2 272 642 participants and 2905 cases, and 8 case–control studies, involving 1825 cases and 4652 controls. An extra two cups per day of coffee was associated with a 35% reduction in the risk of HCC (RR 0.65, 95% CI 0.59 to 0.72). The inverse association was weaker for cohorts (RR 0.71, 95% CI 0.65 to 0.77), which were generally of higher quality than case–control studies (RR 0.53, 95% CI 0.41 to 0.69). There was evidence that the association was not significantly altered by stage of liver disease or the presence/absence of high alcohol consumption, high body mass index, type 2 diabetes mellitus, smoking, or hepatitis B and C viruses. An extra two cups of caffeinated and decaffeinated coffee (2 and 3 cohort studies, respectively) were associated with reductions of 27% (RR 0.73, 95% CI 0.63 to 0.85) and 14% (RR 0.86, 95% CI 0.74 to 1.00) in the risk of HCC. However, due to a lack of randomised controlled trials, potential publication bias and there being no accepted definition of coffee, the quality of evidence under the GRADE criteria was ‘very low’.Conclusions Increased consumption of caffeinated coffee and, to a lesser extent, decaffeinated coffee are associated with reduced risk of HCC, including in pre-existing liver disease. These findings are important given the increasing incidence of HCC globally and its poor prognosis. |
| format | Article |
| id | doaj-art-783457634c464619824ef04b7d2ae471 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2017-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-783457634c464619824ef04b7d2ae4712025-02-09T12:30:09ZengBMJ Publishing GroupBMJ Open2044-60552017-05-017510.1136/bmjopen-2016-013739Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysisPaul Roderick0Peter Clive Hayes1Julie Parkes2Ryan Buchanan3Oliver John Kennedy4Jonathan Andrew Fallowfield5Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK3 Division of Health Sciences, University of Edinburgh, Edinburgh, UK1 Primary Care and Population Sciences Faculty of Medicine, University of Southampton, Southampton, UKFaculty of Medicine, University of Southampton, Southampton, UK1 Primary Care and Population Sciences Faculty of Medicine, University of Southampton, Southampton, UKQueens Medical Research Institute, University of Edinburgh MRC Centre for Inflammation Research, Edinburgh, UKObjectives To examine the association between coffee, including caffeinated and decaffeinated coffee, with hepatocellular carcinoma (HCC) and assess the influence of HCC aetiology and pre-existing liver disease.Design We performed a systematic review and meta-analysis. We calculated relative risks (RRs) of HCC according to caffeinated and decaffeinated coffee consumption using a random-effects dose–response meta-analysis. We tested for modification of the effect estimate by HCC aetiology and pre-existing liver disease. We judged the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.Results We found 18 cohorts, involving 2 272 642 participants and 2905 cases, and 8 case–control studies, involving 1825 cases and 4652 controls. An extra two cups per day of coffee was associated with a 35% reduction in the risk of HCC (RR 0.65, 95% CI 0.59 to 0.72). The inverse association was weaker for cohorts (RR 0.71, 95% CI 0.65 to 0.77), which were generally of higher quality than case–control studies (RR 0.53, 95% CI 0.41 to 0.69). There was evidence that the association was not significantly altered by stage of liver disease or the presence/absence of high alcohol consumption, high body mass index, type 2 diabetes mellitus, smoking, or hepatitis B and C viruses. An extra two cups of caffeinated and decaffeinated coffee (2 and 3 cohort studies, respectively) were associated with reductions of 27% (RR 0.73, 95% CI 0.63 to 0.85) and 14% (RR 0.86, 95% CI 0.74 to 1.00) in the risk of HCC. However, due to a lack of randomised controlled trials, potential publication bias and there being no accepted definition of coffee, the quality of evidence under the GRADE criteria was ‘very low’.Conclusions Increased consumption of caffeinated coffee and, to a lesser extent, decaffeinated coffee are associated with reduced risk of HCC, including in pre-existing liver disease. These findings are important given the increasing incidence of HCC globally and its poor prognosis.https://bmjopen.bmj.com/content/7/5/e013739.full |
| spellingShingle | Paul Roderick Peter Clive Hayes Julie Parkes Ryan Buchanan Oliver John Kennedy Jonathan Andrew Fallowfield Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis BMJ Open |
| title | Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis |
| title_full | Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis |
| title_fullStr | Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis |
| title_full_unstemmed | Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis |
| title_short | Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis |
| title_sort | coffee including caffeinated and decaffeinated coffee and the risk of hepatocellular carcinoma a systematic review and dose response meta analysis |
| url | https://bmjopen.bmj.com/content/7/5/e013739.full |
| work_keys_str_mv | AT paulroderick coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis AT peterclivehayes coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis AT julieparkes coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis AT ryanbuchanan coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis AT oliverjohnkennedy coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis AT jonathanandrewfallowfield coffeeincludingcaffeinatedanddecaffeinatedcoffeeandtheriskofhepatocellularcarcinomaasystematicreviewanddoseresponsemetaanalysis |