Coffee and tea intake
Coffee does not cause cancer and is probably protective against liver and womb cancer. Very hot drinks of any kind may raise oesophageal cancer risk.
IARC reclassified coffee in 2016 from 'possibly carcinogenic' (Group 2B, a 1991 verdict driven by confounding with smoking) to 'not classifiable' (Group 3), while classifying very hot beverages above 65 C as Group 2A for oesophageal squamous cell carcinoma. Umbrella reviews of prospective cohorts show coffee consumption associated with lower risk of hepatocellular carcinoma (about 30-40% lower per 2-3 cups/day, the most consistent finding, including in people with liver disease) and endometrial cancer, and with lower cancer mortality; associations with other sites are null. After diagnosis, coffee intake was associated with lower recurrence and death in the CALGB 89803 colon cancer cohort and in advanced colorectal cancer (CALGB 80405), findings that are hypothesis-generating and unconfirmed by trials. Green tea and its catechins have not delivered in randomised chemoprevention trials (prostate, breast). This is an example of an exposure that generates endless headlines but has a stable, modest evidence base: coffee is safe, probably good for the liver, and not a treatment.
How it works
Coffee polyphenols, diterpenes and caffeine improve insulin sensitivity, reduce hepatic fibrosis markers and induce hepatic detoxifying enzymes; the protective association is strongest where those mechanisms are most relevant (liver, endometrium).
- Large, consistent cohort evidence
- IARC review resolved earlier confounded signal
- No downside for most people
- Observational only
- Reverse causation and residual confounding possible
- Overinterpreted in survivorship
Latest papers
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