“We want to do a lot of stuff; we’re not in great shape. We didn’t get a good night’s sleep. We’re a little depressed. Coffee solves all these problems in one delightful little cup.” – Jerry Seinfeld
Although comedian Jerry Seinfeld pinned down the issues that are solved by our nation’s preferred beverage (satirically, of course), you’ll be elated to learn that there’s more to the picture. So, grab your favorite mug, brew your favorite coffee, and prepare for enlightenment.
Between the years 2003-2012, data from the National Health and Nutrition Examination Survey (NHANES) reported that 75% of US adults 20 years of age or older consumed coffee regularly [1], a statistic which requires little to no convincing. Due to its high rate of consumption, coffee has caused great contention amongst public health professionals and physicians regarding its potential impact on population health. Due to the retrospective nature of most studies carried out on this topic, there has been much conflict surrounding the results; however, in recent years, coffee has taken on a more positive position in regard to health outcomes as we begin to better understand its pharmacology. Contrary to prior sentiments, novel approaches in epidemiological and experimental studies are beginning to show an association between coffee consumption and a reduced risk of a myriad of chronic and degenerative diseases [2]. Yes, cancer happens to be one of those diseases.
In 2016, a robust meta-analysis published in Scientific Reports reviewed a total of 105 prospective studies which produced some very exciting results. This report found an inverse relationship between coffee intake and the risk of oral, pharyngeal, liver, colon, prostate, and endometrial cancers as well as melanoma [3]. Specifically, consumption of coffee was associated with an 11% reduced likelihood of developing prostate cancer and melanoma. Furthermore, there was an impressive 54% risk reduction of liver cancer in coffee drinkers as compared to non-coffee drinkers. Interestingly, the researchers noted a 118% increase in the likelihood of developing lung cancer in those who consume coffee. However, it should be acknowledged that high coffee intake is often associated with cigarette smoking, which more than likely confounded this result [4].
Another meta-analysis published in 2011 in the World Journal of Gastroenterology assessed 14 cohort studies from three different databases to determine if there is an association between coffee consumption and pancreatic cancer, one of the most aggressive malignancies with a dismal 5-year survival rate of 8% [5]. Dong et al. found that the risk of pancreatic cancer was reduced by 18% in those who consumed coffee regularly, and an incredible 32% in heavy drinkers [6]. Unfortunately, the researchers did not explicitly identify what constituted heavy consumption. Some of the cohort studies included in this review reported highest consumption at two or more cups a day, while others reported the highest consumption at seven or more cups a day. Although high coffee intake demonstrated a reduced pancreatic cancer risk in this study, caution is encouraged when consuming large amounts of this beverage due to the potential adverse effects of copious caffeine (i.e., headache, insomnia, irritability, fast heartbeat, and more).
At this point, the inquisitive reader may be asking, what is it in coffee that is protecting our bodies from cancer? Surprisingly, coffee is known to contain over 1000 bioactive components [7]. The particular profile of compounds in any one cup may vary depending upon the coffee species (Arabica or Robusta), roasting, and processing methods [2]. Key active compounds include caffeine, chlorogenic acids, and two diterpenes known as cafestol and kahweol [8]. Caffeine and its metabolites exhibit a wide range of biological functions including antioxidant, antiproliferative, and anti-inflammatory effects [9]. Additionally, the six chlorogenic acids commonly found in coffee (3-CQA, 4-CQA, 5-CQA, 3,4-diCQA, 3,5-diCQA, and 4,5-diCQA) are backed by some substantial evidence to maintain antioxidant and anti-inflammatory properties [10]. Lastly and perhaps most importantly, cafestol and kahweol appear to suppress the levels of specificity protein 1 (Sp1), a protein involved in regulation of cell growth, apoptosis, tumor suppressor genes, oncogenes and angiogenesis which is highly expressed in several cancers including breast, thyroid, liver, pancreatic, colorectal, gastric and lung cancers [11-16]. And if this is not enough, it should be noted that there are other compounds found in coffee beyond those listed here that have potential anti-neoplastic effects.
The tale told here about coffee and cancer represents a beautiful intersection between clinical research and basic science. With such promising data supporting the association between coffee consumption and the reduced risk of several types of cancer, it is reassuring to see a connection made at the biochemical and molecular level. Despite these findings, more investigation is currently underway to understand whether the observed associations between coffee and cancer are truly causal and not just correlational. Although the title of this article may be a bit exaggerated, you may now sip your coffee with a little more confidence than ever before.
- Rehm, C.D., et al., Coffee Consumption among Adults in the United States by Demographic Variables and Purchase Location: Analyses of NHANES 2011-2016 Data. Nutrients, 2020. 12(8).
- Nieber, K., The Impact of Coffee on Health. Planta Med, 2017. 83(16): p. 1256-1263.
- Wang, A., et al., Coffee and cancer risk: A meta-analysis of prospective observational studies. Sci Rep, 2016. 6: p. 33711.
- Leviton, A. and L. Cowan, A review of the literature relating caffeine consumption by women to their risk of reproductive hazards. Food Chem Toxicol, 2002. 40(9): p. 1271-310.
- Siegel, R.L., K.D. Miller, and A. Jemal, Cancer statistics, 2016. CA Cancer J Clin, 2016. 66(1): p. 7-30.
- Dong, J., J. Zou, and X.F. Yu, Coffee drinking and pancreatic cancer risk: a meta-analysis of cohort studies. World J Gastroenterol, 2011. 17(9): p. 1204-10.
- Jeszka-Skowron, M., A. Zgoła-Grześkowiak, and T. Grześkowiak, Analytical methods applied for the characterization and the determination of bioactive compounds in coffee. European Food Research and Technology, 2015. 249: p. 19-31.
- Poole, R., et al., Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ, 2017. 359: p. j5024.
- Moreno-Ceballos, M., et al., Chemopreventive effect of coffee against colorectal cancer and hepatocellular carcinoma. International Journal of Food Properties, 2019. 22(1): p. 536-555.
- Liang, N. and D.D. Kitts, Role of Chlorogenic Acids in Controlling Oxidative and Inflammatory Stress Conditions. Nutrients, 2016. 8(1): p. 16.
- Bai, X. and H. Deng, [Research progress on relationship between transcription factor Sp1 and tumor]. Zhejiang Da Xue Xue Bao Yi Xue Ban, 2010. 39(2): p. 215-20.
- Chuang, J.Y., et al., Overexpression of Sp1 leads to p53-dependent apoptosis in cancer cells. Int J Cancer, 2009. 125(9): p. 2066-76.
- Davie, J.R., et al., Nuclear organization and chromatin dynamics–Sp1, Sp3 and histone deacetylases. Adv Enzyme Regul, 2008. 48: p. 189-208.
- Kong, L.M., et al., Transcription factor Sp1 regulates expression of cancer-associated molecule CD147 in human lung cancer. Cancer Sci, 2010. 101(6): p. 1463-70.
- Lee, K.A., J.I. Chae, and J.H. Shim, Natural diterpenes from coffee, cafestol and kahweol induce apoptosis through regulation of specificity protein 1 expression in human malignant pleural mesothelioma. J Biomed Sci, 2012. 19: p. 60.
- Sankpal, U.T., et al., Targeting Sp1 transcription factors in prostate cancer therapy. Med Chem, 2011. 7(5): p. 518-25.
Ankedo Warda is a member of The University of Arizona College of Medicine - Phoenix, Class of 2024. He graduated with his BS in Exercise, Health and Wellness at Arizona State University before earning his MMS (Master in Medical Studies) at The University of Arizona College of Medicine - Phoenix as part of the Pathway Scholars Class of 2020. Ankedo is interested in the fields of emergency medicine and orthopedic surgery. During leisure, Ankedo enjoys spending time with his family, weight-training and drawing.