飲用咖啡與癌症風險：系統回顧暨統合分析

Coffee Consumption and Cancer Risk: a Systematic Review and Meta-analysis

蔡崇煌(Chung-Huang Tsai) ； 張加憲(Chia-Hsien Chang) ； 張金堅(King-Jen Chang) ； 黃青真(Ching-jang Huang) ； 林高德(Gau-De Lin)

《台灣營養學會雜誌》 43卷4期 (2019/12) Pp. 111-120

https://doi.org/10.6691/NSJ.201912_43(4).0002

摘要

背景：咖啡對癌症之風險引人關注，我們搜尋各器官癌症風險與飲用咖啡的統合分析文獻，進行全面性系統回顧並再做一統合分析。方法：以coffee AND（cancer or tumor or neoplasm or malignancy or malignant or carcinoma）為關鍵詞，搜尋PubMed Medline、Cochrane及Web of Science等資料庫。再以關鍵詞（meta-analysis or pooled analysis or systematic review）搜尋近5年各器官癌症統合分析文獻。挑選出之文獻統合分析之勝算比（ORs）、95%信賴區間（CIs），再使用Comprehensive Meta-Analysis 3.0執行統合分析，結果以MS-Excel及其VBA做森林圖（forest plot）以呈現。結果：共找到19個器官部位癌症之20篇相關文獻做引用，結果為排除兒童白血病後，飲用咖啡可顯著降低整體癌症風險（OR：0.91；95%CI：0.85～0.97）。器官中達統計學上顯著益處者包括：腦（OR：0.47；95%CI：0.22～0.98）、口腔及咽（OR：0.69；95%CI：0.57～0.84）、乳房（OR：0.96；95%CI：0.93～1.00）、肝（OR：0.52；95%CI：0.42～0.63）、胰（OR：0.75；95%CI：0.63～0.86）、膀胱（≧3杯／0杯）（OR：0.56；95%CI：0.32～0.99）、子宮內膜（OR：0.74；95%CI：0.68～0.81）、及皮膚之黑色素瘤（OR：0.75；95%CI：0.63～0.89）和非黑色素瘤（OR：0.91；95%CI：0.89～0.93）。增高風險且達統計學上顯著性者，包括：肺（OR：1.09；95%CI：1.00～1.19）、膀胱（OR：1.33；95%CI：1.19～1.48）及母親懷孕期間飲用咖啡之兒童白血病（OR：1.57；95%CI：1.16～2.11），及其中之急性淋巴細胞性白血病（ALL）（OR：1.43；95%CI：1.22～1.68）。結論：母親懷孕期間飲用咖啡與兒童白血病有關，除此外，飲用咖啡可降低整體及部份器官之罹癌風險。

關鍵字

癌 ； 統合分析 ； 系統回顧 ； 懷孕

並列摘要

Background: Coffee has attracted attention as a risk of cancer. We searched for meta-analyses in the literature of cancer in various organs to compile a comprehensive systematic review and then performed a meta-analysis. Materials and methods: The keywords were ＂coffee＂ AND (＂cancer＂ or ＂tumor＂ or ＂neoplasm＂ or ＂malignancy＂ or ＂malignant＂ or ＂carcinoma＂), and databases such as PubMed Medline, Cochrane, and Web of Science were searched. We used the keywords (＂meta-analysis＂ or ＂pooled analysis＂ or ＂systematic review＂) to search for meta-analysis literature of various organs. We searched for odds ratios (ORs), 95% confidence intervals (Cis), and heterogeneity (I^2) of meta-analyses in the literature and used Comprehensive Meta-Analysis 3.0 software to perform a meta-analysis. A forest plot was drawn with MS-Excel and its Visual Basic for Applications according to the results. Results: In total, 20 related studies involving 19 organs were found. The results showed that coffee was beneficial, and statistically significant differences were found overall (OR: 0.91; 95% CI: 0.85~0.97) after excluding childhood leukemia for cancers of the brain (OR: 0.47; 95% CI: 0.22~0.98), oral cavity and pharynx (OR: 0.69; 95% CI: 0.57~0.84), breast (OR: 0.96; 95% CI: 0.93~1.00), liver (OR: 0.52; 95% CI: 0.42~0.63), pancreas (OR: 0.75; 95% CI: 0.63~0.86), bladder (≥3 cups/0 cup)(OR: 0.56; 95% CI: 0.32~0.99), and endometrium (OR: 0.74; 95% CI: 0.68~0.81), as well as melanomas (OR: 0.75; 95% CI: 0.63~0.89), and non-melanomas (OR: 0.91; 95% CI: 0.89~0.93). The most harmful aspects of coffee were statistically significant differences in lung cancer (OR: 1.09; 95% CI: 1.00~1.19), bladder cancer (OR: 1.33; 95% CI: 1.19~1.48), overall childhood leukemia (OR: 1.57; 95% CI: 1.16~2.11), and acute lymphoblastic leukemia (ALL) (OR: 1.43; 95% CI: 1.22~1.68) during pregnancy. Conclusions: In general, coffee consumption can reduce the risk of cancer overall and in some organs, except coffee consumption during pregnancy is related to childhood leukemia.

並列關鍵字

cancer ； meta-analysis ； systematic review ； pregnancy