Increased coffee consumption among patients with advanced or metastatic colorectal cancer (CRC) may be associated with reduced risk for disease progression and death, according to study results published in JAMA Oncology.

This prospective observational study analyzed a subset of data (N=1171) from the phase 3, randomized Cancer and Leukemia Group B study. Patients with advanced or metastatic CRC received fluorouracil and chemotherapy with either leucovorin calcium and irinotecan hydrochloride or leucovorin and oxaliplatin. Patients were allowed to enroll in an optional diet and lifestyle companion study that collected data between 2005 and 2018. Participants responded to a semiquantitative food frequency questionnaire that assessed 131 food items and supplements.

At baseline, median participant age was 59 years (interquartile range [IQR], 51.67); 59% of participants were men, and 86% were White. The majority of patients (93%) experienced disease progression or died after a median follow-up of 5.4 years (IQR, 3.2-6.3).

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Frequent coffee drinkers (≥4 cups/d) were more likely to be White men with a history of smoking, a higher median daily calorie intake, and a higher median alcohol consumption.

For every cup of coffee per day, investigators observed an improvement in overall survival (hazard ratio [HR], 0.93; 95% CI, 0.89-0.98; P =.04). Compared with patients who never drank coffee, those who drank 2 or 3 cups per day (HR, 0.82; 95% CI, 0.67-1.00) or 4 or more cups per day (HR, 0.64; 95% CI, 0.46-0.87) had reduced risk for mortality.

For every cup of coffee per day, progression-free survival was also improved (HR, 0.95; 95% CI, 0.91-1.00; P =.04). Compared with those who never drank coffee, consuming 2 or 3 cups per day had a progression-free survival HR of 0.82 (95% CI, 0.68-0.99) and consuming at least 4 cups per day had a progression-free survival HR of 0.78 (95% CI, 0.59-1.05).

This observed trend was largely independent of caffeine. Compared with coffee abstainers, those who drank at least 2 cups of decaffeinated coffee had an improved risk for overall survival (HR, 0.64; 95% CI, 0.43-0.95; P =.003) and progression-free survival (HR, 0.75; 95% CI, 0.52-1.09; P =.05); for those who consumed at least 4 cups of caffeinated coffee, the overall survival risk HR was 0.66 (95% CI, 0.47-0.94; P =.04).

Study limitations included an inability of the researchers to discern whether the observed benefit of coffee consumption resulted from life-time consumption or whether in the short-term, coffee interacted with active tumors.

“This large cohort study detected an association between increased consumption of coffee and improved CRC outcomes,” the researchers concluded. “These findings are consistent with those of previous epidemiological studies, although this is the first…to our knowledge, to show a protective effect…in patients with advanced or metastatic CRC.” Future studies are required to ascertain the underlying mechanisms driving these observations.

Disclosure: This clinical trial was supported by Genentech, Inc., Sanofi, and Pfizer, Inc. Please see the original reference for a full list of authors’ disclosures.


Mackintosh C, Yuan C, Ou F-S, et al. Association of coffee intake with survival in patients with advanced or metastatic colorectal cancer. JAMA Oncol. Published online September 17, 2020. doi:10.1001/jamaoncol.2020.3938 

This article originally appeared on Gastroenterology Advisor