Coffee consumption and pancreatic cancer
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Coffee consumption and pancreatic cancer Tomoyuki Kawada1 Received: 5 June 2019 / Accepted: 16 July 2019 © Springer Nature B.V. 2019
Keywords Coffee consumption · Pancreatic cancer · Risk assessment I have read the article by Lukic et al. [1] with great interest. The authors evaluated the association between filtered, boiled, and total coffee consumption and the risk of bladder, esophageal, kidney, pancreatic, and stomach cancers. Adjusted hazard ratios (HR) (95% confidence interval [CI]) of heavy filtered coffee consumers (≥ 4 cups/day) against light filtered coffee consumers (≤ 1 cup/day) for pancreatic cancer was 0.74 (0.57–0.95). I have some concerns about risk reduction of pancreatic cancer by increasing filtered coffee consumption. First, there is a meta-analysis to examine the association between heavy coffee consumption and pancreatitis [2], and pooled risk ratio (RR) (95% CI) of heavy coffee-drinkers against no heavy coffee-drinkers for pancreatitis was 0.78 (0.67–0.91). In contrast, Nie et al. [3] conducted a metaanalysis by compiling prospective studies, and the pooled relative risk (RR) of the highest against lowest category of coffee intake for pancreatic cancer was not significant. There are also non-significant reports for the risk of coffee consumption on pancreatic cancer by a meta-analysis. Turati et al. [4] reported no significant association. There is a need of presenting clear inclusion and exclusion criteria, according to a recommendation from the Cochrane Collaboration that high heterogeneity of the results should be avoided. The heterogeneity between studies included in meta-analyses by Nie et al. was high and those by Wijarnpreecha et al. and Turati et al. were low. Taken together, caution should be paid to the quality of each paper and also heterogeneity of each meta-analysis. Second, Kirkegård et al. [5] conducted a meta-analysis to examine the association between chronic pancreatitis and pancreatic cancer by considering periods after chronic
pancreatitis. Pooled effect estimates of chronic pancreatitis for pancreatic cancer within 2 years of follow-up significantly increased. When the follow-up periods were increased to 5 and ≥ 9 years, the effect estimates (95% CIs) of chronic pancreatitis for pancreatic cancer were 7.90 (4.26–14.66) and 3.53 (1.69–7.38), respectively. Chronic pancreatitis is a precursor or one of the epidemiological confounders of pancreatic cancer, and preventive behavior for pancreatitis is important for subsequent cancer incidence. Finally, the stratified analysis by sex and/or smoking status was limited, and Zhou et al. [6] conducted a prospective study to evaluate the effect of coffee consumption on the risk of pancreatic cancer incidence in female never-smokers, presenting no significant relationship. In contrast, Dong et al. [7] reported that the pooled RRs (95% CIs) of regular coffee drinkers, low to moderate coffee drinkers and high drinkers vs. no intake or seldom coffee intake for pancreatic cancer incidence were 0.82 (0.69–0.95), 0.86 (0
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