Coffee consumption and cancer incidence and mortality: a Global Cancer Update Programme (CUP Global) systematic literature review
MARKOZANNES G. 1,2, CIVIDINI S. 1, VIEIRA R. 1, JAYEDI A. 1, PAGKALIDOU E. 1,2, AUNE D. 1, CARIOLOU M. 1, TSILIDIS K. 1,2, CHAN D. 1
1 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; 2 Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
Background: Coffee is one of the most widely consumed beverages worldwide, containing numerous bioactive compounds with potential antioxidant and anti-inflammatory properties. Epidemiological evidence suggests potential protective associations for liver and endometrial cancers, though findings remain inconsistent across other cancer sites and coffee types.
Objectives: This systematic literature review and meta-analysis, conducted within the World Cancer Research Fund International CUP Global framework, aimed to comprehensively evaluate associations between coffee consumption and cancer incidence and mortality at several anatomical sites.
Methods: We searched PubMed and Embase from inception to 31 May 2025 for prospective studies investigating the association of total, caffeinated, and decaffeinated coffee consumption, and brewing methods with risk of adult mouth, pharynx, larynx, colorectal, liver, skin, endometrial, prostate, and brain and other central nervous system cancers. We conducted linear and non-linear dose-response meta-analyses and estimated the sources of between-study heterogeneity across pre-specified subgroup and sensitivity analyses. Risk of bias was evaluated using a modified version of the Risk of Bias for Nutrition Observational Studies (RoB-Nobs) tool.
Results: We included 104 publications comprising 67 cohorts that included 194,104 cancer cases and 29,626 cancer deaths. Preliminary analyses show that total coffee consumption was linearly associated with a lower risk of incident liver (RR per 1 cup/day: 0.85, 95%CI: 0.80–0.90; I2: 67%; 19 studies), melanoma (RR: 0.96, 95%CI: 0.94–0.98; I2: 0%; 6 studies), endometrial (RR: 0.94, 95%CI: 0.92–0.97;I2: 53.6%; 16 studies), and localised prostate cancer (RR: 0.98, 95%CI: 0.97–0.99; I2: 0%; 5 studies), and mortality of liver (RR: 0.96, 95%CI: 0.94–0.98; I2: 0%; 5 studies) and prostate cancer (RR: 0.97, 95% CI: 0.94–0.99; I2: 57.2%; 7 studies). Caffeinated coffee consumption was linearly associated with lower risk of incident basal cell carcinoma of the skin (RR: 0.96, 95%CI: 0.94–0.97; I2: 14.4%; 4 studies). Decaffeinated coffee consumption was linearly associated with lower risk of colorectal (RR: 0.97, 95%CI: 0.95–0.98; I2: 3.4%; 6 studies), colon (RR: 0.97, 95%CI: 0.96–0.99; I2: 0%; 6 studies), endometrial (RR: 0.95, 95%CI: 0.90–0.99; I2: 18.4%; 4 studies), and advanced prostate cancer incidence (RR: 0.92, 95%CI: 0.86–0.99; I2: 0%; 2 studies). Results for brain cancers were null across the exposures. Subgroup analyses indicated stronger inverse associations for total coffee and endometrial cancer among women with higher body mass index. The few results for brewing methods and sugar addition were largely null. No meta-analyses were possible for head and neck cancers. Most studies were rated as having critical (44%) risk of bias largely due to inadequate adjustment for key confounders.
Conclusion: Our findings indicate that coffee consumption is associated with lower risk of liver, prostate, endometrial and skin cancers. These results support coffee as a safe beverage with potential protective benefits against certain cancers. Future studies should incorporate harmonised and biomarker-validated exposure measures, more comprehensive adjustment for confounders, account for additives and preparation methods, include more diverse populations, and better elucidate underlying biological mechanisms.