Coffee and tea consumption and risk of hepatocellular carcinoma in Italy

Abstract

The role of coffee in the aetiology of hepatocellular carcinoma has raised great interest. In Italy, coffee consumption is high, thus allowing the investigation of the topic over a broad range of consumption. A hospital-based case-control study was conducted in Italy in [1999][2000][2001][2002], including 185 incidents, histologically confirmed cases of hepatocellular carcinoma aged 43-84 years. Controls were 412 subjects admitted to the same hospitals' networks for acute, non-neoplastic diseases unrelated to diet. Coffee and tea consumption were assessed using a validated food-frequency questionnaire. Odds ratios (ORs) and corresponding the 95% confidence intervals (CI) were computed using unconditional multiple logistic regression, adjusting for hepatitis viruses seropositivity, alcohol intake, smoking habits and other potential confounding factors. Compared to people who drunk <14 cups/week of coffee, the risk of hepatocellular carcinoma decreased for increasing levels of consumption (OR 5 0.4, 95% CI: 0.2-1.1 for 28 cups/week, p for trend 5 0.02). In the present study, inverse relations were observed across strata of hepatitis C and B virus infections and alcohol drinking. No significant association emerged with consumption of decaffeinated coffee (OR 5 0.7, 95% CI 5 0.2-2.5) or tea (OR 5 1.4, 95% CI 5 0.8-2.7). The present study supports the hypothesis of a favourable effect of coffee, though not decaffeinated coffee and tea, on the risk on hepatocellular carcinoma. ' 2006 Wiley-Liss, Inc.Key words: coffee; tea; hepatocellular carcinoma; case-control study Hepatocellular carcinoma (HCC) is a highly fatal cancer that, in Italy, accounts for 3.4% of all newly diagnosed cancers among men and for 1.9% among women. 1 Likewise, the burden of HCC on total cancer mortality was 4.4% among men and 2.7% among women. 2 Incidence and mortality have shown upward trends in most of the developed countries, 3-5 including Italy. 3 The major known risk factors are persistent infections with hepatitis C virus (HCV) and hepatitis B virus (HBV), 6 but other prevalent medical conditions (i.e., liver cirrhosis) or socio-demographic factors, such as alcohol drinking and tobacco smoking, may play an important role in HCC onset. 6,7 Several studies from Europe, Japan, and United States reported an inverse relation between coffee consumption, g-glutamyltransferase (GGT) 8-10 and alanine aminotransferase (ALT) 10,11 levels, which are markers of liver injuries. Recently, increasing evidence has emerged on the relation between coffee drinking and risk of cirrhosis 12-14 and HCC. [15][16][17][18] A consistent inverse association with coffee consumption against HCC was found in cohort 15,[17][18][19] and case-control studies. 16,20,21 A few studies have investigated tea consumption in relation to HCC incidence and mortality, 14,15,19,22 and their results were inconclusive.Italy ranked among the top European countries according to annual pro-capite consumption of coffee (about 6 kg) (www.ico.org). The present paper, based on a case-control ...

Liver cancer risk, coffee, and hepatitis C virus infection: a nested case–control study in Japan

“…Our results from this prospective cohort study support the findings in some (Gelatti et al, 2005;Ohfuji et al, 2006), although not all (Montella et al, 2007), case-control studies that suggested a protective effect of coffee among HCV-positive individuals. Some patients with hepatitis or liver cirrhosis, however, may have decreased coffee consumption at their physician's advice or due to impaired caffeine metabolism in the liver (Hasegawa et al, 1989).…”

“…The inverse associations between coffee consumption and the risk of hepatocellular carcinoma (HCC) have recently been reported not only from case -control studies (Gallus et al, 2002;Gelatti et al, 2005;Ohfuji et al, 2006;Montella et al, 2007;Tanaka et al, 2007) but also from Japanese cohort studies (Inoue et al, 2005;Kurozawa et al, 2005;Shimazu et al, 2005). Cohort studies are superior to case -control studies in avoiding recall and selection bias (Ohfuji et al, 2006).…”

Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: Multicentre, prospective cohort study

“…In a recent meta-analysis, 8 including all indicated studies, as well as three studies reporting statistically nonsignificant inverse 19,26 or null 27 associations, the summary relative risk for HCC for any versus no coffee consumption was 0.60 (95% CI, 0.50-0.71), with a dose-response trend. With the exception of one Italian case-control study, 25 studies on tea consumption and HCC risk have been conducted exclusively in Asia (where green tea consumption is more frequent than in Europe); the results are collectively inconclusive. Two studies reported statistically significant inverse associations, 28,29 four inverse but statistically nonsignificant associations, [30][31][32][33] two null associations, 19,34 whereas three reported positive, albeit statistically nonsignificant associations.…”

“…Two studies reported statistically significant inverse associations, 28,29 four inverse but statistically nonsignificant associations, [30][31][32][33] two null associations, 19,34 whereas three reported positive, albeit statistically nonsignificant associations. 17,25,35 A meta-analysis of these studies 9 pointed to a suggestive inverse association of tea with primary liver cancer. Our study, the first cohort study outside Asia, indicates an inverse, dose-dependent association of tea with HCC risk, which is not incompatible with the results of the indicated meta-analysis, although our findings point to a stronger inverse association.…”

Green tea and liver cancer

“…Outside Asia, three studies investigated the role of tea on liver cancer (11)(12)(13). They were conducted among European populations, where the tea-drinking culture is less frequent and black rather than green tea is usually consumed.…”