Full Report - Food, Nutrition, and the Prevention of Cancer

cant decreased risk in men. 74 Meta-analysis was possible on
eight cohort studies, giving a summary effect estimate of
1.00 (95% CI 0.94–1.07) per cup/day, with low heterogeneity
(figure 4.7.1).
Some, though not all, of the cohort studies suggest a Jshaped
dose-response relationship. An effect at high levels
of coffee consumption cannot be excluded.
77 84-119
Case-control studies reported inconsistent results.
84-87 89-91 94 97 99 102-
Eighteen studies reported increased risk,
106 112 114 116 119 85
of which nine were statistically significant.
87 94 102 112 114 Eleven studies reported decreased risk, 77 92 93 95
Figure 4.7.1 Coffee and pancreatic cancer; cohort and
case-control studies
154
Cohort
Snowdon 1984 0.98 (0.69–1.40)
Zheng 1993 Men 0.93 (0.81–1.08)
Shibata 1994 1.13 (0.79–1.62)
Stensvold 1994 Men 0.97 (0.83–1.14)
Stensvold 1994 Women 1.08 (0.85–1.37)
Harnack 1997 Women 1.24 (1.02–1.49)
Michaud 2001 Men 0.86 (0.74–1.00)
Michaud 2001 Women 0.96 (0.87–1.07)
Lin 2002 Men 1.14 (0.92–1.41)
Lin 2002 Women 0.86 (0.58–1.26)
Stolzenberg-Solomon 2002 Men 1.05 (0.94–1.17)
Summary estimate 1.00 (0.94–1.07)
Case control
Elinder 1981 0.85 (0.66–1.09)
MacMahon 1981 1.13 (1.05–1.23)
Wynder 1983 Men 1.01 (0.93–1.10)
Wynder 1983 Women 1.00 (0.90–1.10)
Gold 1985 1.06 (0.89–1.26)
Mack 1986 1.20 (1.07–1.34)
La Vechhia 1987 1.06 (0.89–1.27)
Gorham 1988 1.15 (0.98–1.35)
Falk 1988 Men 1.09 (1.03–1.16)
Falk 1988 Women 1.06 (0.97–1.15)
Clavel 1989 Women 2.00 (1.22–3.28)
Olsen 1989 All respondents 0.97 (0.87–1.08)
Clavel 1989 Men 1.32 (0.91–1.92)
Cuzick 1989 0.93 (0.83–1.05)
Farrow 1990 Men 1.03 (0.94–1.13)
Jain 1991 1.00 (1.00–1.00)
Ghadirian 1991 0.99 (0.93–1.05)
Bueno de Mesquita 1992 0.78 (0.61–1.00)
Stefanati 1992 1.14 (0.80–1.62)
Lyon 1992 1.15 (1.02–1.30)
Zatonski 1993 0.53 (0.27–1.02)
Kalapothaki 1993 0.85 (0.68–1.06)
Sciallero 1993 1.02 (0.84–1.24)
Partanen 1995 0.97 (0.92–1.03)
Gullo 1995 1.25 (1.12–1.40)
Silverman 1998 Men 1.05 (0.98–1.13)
Silverman 1998 Women 1.03 (0.94–1.13)
Villeneuve 2000 Men 1.05 (0.94–1.17)
Villeneuve 2000 Women 0.99 (0.88–1.12)
Kreiger 2001 Women 1.00 (0.77–1.32)
Summary estimate 1.04 (1.01–1.07)
0.5
0.8 1 1.2 2
Relative risk, per cup/day
Relative risk (95% CI)
P ART 2 • EVIDENCE AND JUDGEMENTS
96 101 107 109 111 113 118 which was statistically significant in
one. 118 Three studies showed no effect on risk 88 98 and one
study stated there was no significant effect on risk. 110 Four
other studies reported different effects in men and women;
however none was statistically significant. 100 108 115 117 Metaanalysis
was possible on 26 studies, giving a summary effect
estimate of 1.04 (95% CI 1.01–1.07) per cup/day, with moderate
heterogeneity (figures 4.7.1 and 4.7.2). Studies that
did not adjust for smoking behaviour were more likely to
report increased risk. Confounding with smoking could not
be excluded.
The ecological studies overall showed an increased mortality
between coffee consumption and pancreatic cancer. 120-
130 Correlation coefficients ranged from +0.15 122 to
124 125
+0.59.
There is ample evidence, including prospective data,
which is consistent and with low heterogeneity, and
which fails to show an association. It is unlikely that
coffee has any substantial effect on the risk of
pancreatic cancer.
Figure 4.7.2 Coffee and pancreatic cancer;
cohort studies: dose response
Snowdon 1984
Zheng 1993
Shibata 1994
Stensvold 1994 Men
Stensvold 1994 Women
Honack 1997 Women
Michaud 2001 Men
Michaud 2001 Women
Lin 2002 Men
Lin 2002 Women
Stolzenberg-Solomon
2002 Men
0 2 4 6 8 10
Coffee (cups/day)