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Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis

Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis
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 (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.
2044-6055
1-14
Kennedy, Oliver John
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Roderick, Paul
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Buchanan, Ryan
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Fallowfield, Jonathan Andrew
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Hayes, Peter Clive
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Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Kennedy, Oliver John
96f5e8fc-f18e-4887-8504-77ffef83c7f1
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Fallowfield, Jonathan Andrew
ba8f5afe-819a-4f8d-a7c5-3799c927c656
Hayes, Peter Clive
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Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984

Kennedy, Oliver John, Roderick, Paul, Buchanan, Ryan, Fallowfield, Jonathan Andrew, Hayes, Peter Clive and Parkes, Julie (2017) Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis. BMJ Open, 7 (5), 1-14, [e013739]. (doi:10.1136/bmjopen-2016-013739).

Record type: Article

Abstract

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.

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Accepted/In Press date: 6 March 2017
e-pub ahead of print date: 9 May 2017
Published date: 9 May 2017

Identifiers

Local EPrints ID: 430848
URI: http://eprints.soton.ac.uk/id/eprint/430848
ISSN: 2044-6055
PURE UUID: 4bfa392f-9ed3-4c34-980c-454cecc34629
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X

Catalogue record

Date deposited: 16 May 2019 16:30
Last modified: 13 Nov 2021 02:39

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Contributors

Author: Oliver John Kennedy
Author: Paul Roderick ORCID iD
Author: Ryan Buchanan
Author: Jonathan Andrew Fallowfield
Author: Peter Clive Hayes
Author: Julie Parkes ORCID iD

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