European Journal of Epidemiology

, Volume 33, Issue 3, pp 287–302 | Cite as

Coffee consumption and risk of rare cancers in Scandinavian countries

  • Marko LukicEmail author
  • Lena Maria Nilsson
  • Guri Skeie
  • Bernt Lindahl
  • Tonje Braaten


Studies on the association between heavy coffee consumption and risk of less frequently diagnosed cancers are scarce. We aimed to quantify the association between filtered, boiled, and total coffee consumption and the risk of bladder, esophageal, kidney, pancreatic, and stomach cancers. We used data from the Norwegian Women and Cancer Study and the Northern Sweden Health and Disease Study. Information on coffee consumption was available for 193,439 participants. We used multivariable Cox proportional hazards models to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the investigated cancer sites by category of total, filtered, and boiled coffee consumption. Heavy filtered coffee consumers (≥ 4 cups/day) had a multivariable adjusted HR of 0.74 of being diagnosed with pancreatic cancer (95% CI 0.57–0.95) when compared with light filtered coffee consumers (≤ 1 cup/day). We did not observe significant associations between total or boiled coffee consumption and any of the investigated cancer sites, neither in the entire study sample nor in analyses stratified by sex. We found an increased risk of bladder cancer among never smokers who were heavy filtered or total coffee consumers, and an increased risk of stomach cancer in never smokers who were heavy boiled coffee consumers. Our data suggest that increased filtered coffee consumption might reduce the risk of pancreatic cancer. We did not find evidence of an association between coffee consumption and the risk of esophageal or kidney cancer. The increased risk of bladder and stomach cancer was confined to never smokers.


Coffee Filtered Boiled Cancer Bladder Esophageal Kidney Pancreatic Stomach Prospective cohort study 



The authors thank the NOWAC Study staff and participants for their contribution. The authors used the services of Trudy Perdix-Thoma for the language editing of the manuscript. We acknowledge the Northern Sweden Diet Database and the funds supporting it, including the Swedish Research Council (VR), the Swedish Research Council for Health, Working Life and Welfare (FORTE) and the Västerbotten County Council.

Sources of funding

Supported by UiT The Arctic University of Norway. The funding sources had no involvement in the design and conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10654_2018_369_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)


  1. 1.
    Bohn SK, Blomhoff R, Paur I. Coffee and cancer risk, epidemiological evidence, and molecular mechanisms. Mol Nutr Food Res. 2014;58(5):915–30.CrossRefPubMedGoogle Scholar
  2. 2.
    Gasscht F, Dicato M, Diederich M. Coffee provides a natural multitarget pharmacopeia against the hallmarks of cancer. Genes Nutr. 2015;10(6):51.CrossRefGoogle Scholar
  3. 3.
    Majer BJ, Hofer E, Cavin C, Lhoste E, Uhl M, Glatt HR, et al. Coffee diterpenes prevent the genotoxic effects of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and N-nitrosodimethylamine in a human derived liver cell line (HepG2). Food Chem Toxicol. 2005;43(3):433–41.CrossRefPubMedGoogle Scholar
  4. 4.
    Shearer J, Farah A, de Paulis T, Bracy DP, Pencek RR, Graham TE, et al. Quinides of roasted coffee enhance insulin action in conscious rats. J Nutr. 2003;133(11):3529–32.CrossRefPubMedGoogle Scholar
  5. 5.
    Higgins LG, Cavin C, Itoh K, Yamamoto M, Hayes JD. Induction of cancer chemopreventive enzymes by coffee is mediated by transcription factor Nrf2. Evidence that the coffee-specific diterpenes cafestol and kahweol confer protection against acrolein. Toxicol Appl Pharmacol. 2008;226(3):328–37.CrossRefPubMedGoogle Scholar
  6. 6.
    Oh JH, Lee JT, Yang ES, Chang JS, Lee DS, Kim SH, et al. The coffee diterpene kahweol induces apoptosis in human leukemia U937 cells through down-regulation of Akt phosphorylation and activation of JNK. Apoptosis. 2009;14(11):1378–86.CrossRefPubMedGoogle Scholar
  7. 7.
    Renehan AG, Roberts DL, Dive C. Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem. 2008;114(1):71–83.CrossRefPubMedGoogle Scholar
  8. 8.
    Kotsopoulos J, Eliassen AH, Missmer SA, Hankinson SE, Tworoger SS. Relationship between caffeine intake and plasma sex hormone concentrations in premenopausal and postmenopausal women. Cancer. 2009;115(12):2765–74.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Urgert R, Katan MB. The cholesterol-raising factor from coffee beans. Annu Rev Nutr. 1997;17:305–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Wu WX, Tong YQ, Zhao Q, Yu GX, Wei XY, Lu Q. Coffee consumption and bladder cancer: a meta-analysis of observational studies. Sci Rep. 2015;5:9051.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Loomis D, Guyton KZ, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, et al. Carcinogenicity of drinking coffee, mate, and very hot beverages. Lancet Oncol. 2016;17(7):877–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Islami F, Boffetta P, Ren JS, Pedoeim L, Khatib D, Kamangar F. High-temperature beverages and foods and esophageal cancer risk—a systematic review. Int J Cancer. 2009;125(3):491–524.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Turati F, Galeone C, Edefonti V, Ferraroni M, Lagiou P, La Vecchia C, et al. A meta-analysis of coffee consumption and pancreatic cancer. Ann Oncol. 2012;23(2):311–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Zeng SB, Weng H, Zhou M, Duan XL, Shen XF, Zeng XT. Long-term coffee consumption and risk of gastric cancer a PRISMA-compliant dose–response meta-analysis of prospective cohort studies. Medicine. 2015;94(38):1–11.CrossRefGoogle Scholar
  15. 15.
    World Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Report: Diet, Nutrition, Physical Activity and Kidney Cancer. 2015. Scholar
  16. 16.
    World Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Report: Food, Nutrition, Physical Activity and the Prevention of Pancreatic Cancer. 2012.
  17. 17.
    International Coffee Council. Trends in coffee consumption in selected importing countries [Internet]. London: International Coffee Organization. 2012.
  18. 18.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRefPubMedGoogle Scholar
  19. 19.
    Lund E, Dumeaux V, Braaten T, Hjartaker A, Engeset D, Skeie G, et al. Cohort profile: The Norwegian Women and Cancer Study—NOWAC—Kvinner og kreft. Int J Epidemiol. 2008;37(1):36–41.CrossRefPubMedGoogle Scholar
  20. 20.
    Hallmans G, Agren A, Johansson G, Johansson A, Stegmayr B, Jansson JH, et al. Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort—evaluation of risk factors and their interactions. Scand J Public Health Suppl. 2003;61:18–24.CrossRefPubMedGoogle Scholar
  21. 21.
    Tognon G, Nilsson LM, Shungin D, Lissner L, Jansson JH, Renstrom F, et al. Nonfermented milk and other dairy products: associations with all-cause mortality. Am J Clin Nutr. 2017;105(6):1502–11.PubMedGoogle Scholar
  22. 22.
    Jr HFE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. New York: Springer; 2001.Google Scholar
  23. 23.
    Bakuradze T, Boehm N, Janzowski C, Lang R, Hofmann T, Stockis JP, et al. Antioxidant-rich coffee reduces DNA damage, elevates glutathione status and contributes to weight control: results from an intervention study. Mol Nutr Food Res. 2011;55(5):793–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Parsons WD, Neims AH. Effect of smoking on caffeine clearance. Clin Pharmacol Ther. 1978;24(1):40–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Campbell ME, Spielberg SP, Kalow W. A urinary metabolite ratio that reflects systemic caffeine clearance. Clin Pharmacol Ther. 1987;42(2):157–65.CrossRefPubMedGoogle Scholar
  26. 26.
    Kurahashi N, Inoue M, Iwasaki M, Sasazuki S, Tsugane S, Japan Public Health Center Study G. Coffee, green tea, and caffeine consumption and subsequent risk of bladder cancer in relation to smoking status: a prospective study in Japan. Cancer Sci. 2009;100(2):284–91.CrossRefGoogle Scholar
  27. 27.
    Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94(446):496–509.CrossRefGoogle Scholar
  28. 28.
    Jacobsen BK, Bjelke E, Kvale G, Heuch I. Coffee drinking, mortality, and cancer incidence: results from a Norwegian prospective study. J Natl Cancer Inst. 1986;76(5):823–31.PubMedGoogle Scholar
  29. 29.
    Porta M, Vioque J, Ayude D, Alguacil J, Jariod M, Ruiz L, et al. Coffee drinking: the rationale for treating it as a potential effect modifier of carcinogenic exposures. Eur J Epidemiol. 2003;18(4):289–98.CrossRefPubMedGoogle Scholar
  30. 30.
    Hukkanen J, Jacob P 3rd, Peng M, Dempsey D, Benowitz NL. Effect of nicotine on cytochrome P450 1A2 activity. Br J Clin Pharmacol. 2011;72(5):836–8.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Gu L, Gonzalez FJ, Kalow W, Tang BK. Biotransformation of caffeine, paraxanthine, theobromine and theophylline by cDNA-expressed human CYP1A2 and CYP2E1. Pharmacogenetics. 1992;2(2):73–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Naganuma T, Kuriyama S, Kakizaki M, Sone T, Nakaya N, Ohmori-Matsuda K, et al. Coffee consumption and the risk of oral, pharyngeal, and esophageal cancers in Japan: the Miyagi Cohort Study. Am J Epidemiol. 2008;168(12):1425–32.CrossRefPubMedGoogle Scholar
  33. 33.
    Stensvold I, Jacobsen BK. Coffee and cancer: a prospective study of 43,000 Norwegian men and women. Cancer Causes Control. 1994;5(5):401–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Nilsson LM, Johansson I, Lenner P, Lindahl B, Van Guelpen B. Consumption of filtered and boiled coffee and the risk of incident cancer: a prospective cohort study. Cancer Causes Control. 2010;21(10):1533–44.CrossRefPubMedGoogle Scholar
  35. 35.
    Bidel S, Hu G, Jousilahti P, Pukkala E, Hakulinen T, Tuomilehto J. Coffee consumption and risk of gastric and pancreatic cancer—a prospective cohort study. Int J Cancer. 2013;132(7):1651–9.CrossRefPubMedGoogle Scholar
  36. 36.
    Guertin KA, Freedman ND, Loftfield E, Stolzenberg-Solomon RZ, Graubard BI, Sinha R. A prospective study of coffee intake and pancreatic cancer: results from the NIH-AARP Diet and Health Study. Brit J Cancer. 2015;113(7):1081–5.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Nilsson ML. Chapter 29—boiled coffee: an arctic example of potential residual and unmeasured confounding in coffee epidemiology. In: Preedy V, editor. Coffee in health and disease prevention. Cambridge: Academic Press; 2014. p. 265–74.Google Scholar
  38. 38.
    Ding M, Bhupathiraju SN, Chen M, van Dam RM, Hu FB. Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis. Diabetes Care. 2014;37(2):569–86.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Bosetti C, Rosato V, Li D, Silverman D, Petersen GM, Bracci PM, et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case–Control Consortium. Ann Oncol. 2014;25(10):2065–72.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Parras P, Martinez-Tome M, Jimenez AM, Murcia MA. Antioxidant capacity of coffees of several origins brewed following three different procedures. Food Chem. 2007;102(3):582–92.CrossRefGoogle Scholar
  41. 41.
    Montella M, Tramacere I, Tavani A, Gallus S, Crispo A, Talamini R, et al. Coffee, decaffeinated coffee, tea intake, and risk of renal cell cancer. Nutr Cancer. 2009;61(1):76–80.CrossRefPubMedGoogle Scholar
  42. 42.
    Ainslie-Waldman CE, Koh WP, Jin A, Yeoh KG, Zhu F, Wang R, et al. Coffee intake and gastric cancer risk: the Singapore Chinese health study. Cancer Epidemiol Biomark Prev. 2014;23(4):638–47.CrossRefGoogle Scholar
  43. 43.
    Lund E, Kumle M, Braaten T, Hjartaker A, Bakken K, Eggen E, et al. External validity in a population-based national prospective study—the Norwegian Women and Cancer Study (NOWAC). Cancer Causes Control. 2003;14(10):1001–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Stegmayr B, Lundberg V, Asplund K. The events registration and survey procedures in the Northern Sweden MONICA Project. Scand J Public Health Suppl. 2003;61:9–17.CrossRefPubMedGoogle Scholar
  45. 45.
    Pukkala E, Andersen A, Berglund G, Gislefoss R, Gudnason V, Hallmans G, et al. Nordic biological specimen banks as basis for studies of cancer causes and control–more than 2 million sample donors, 25 million person years and 100,000 prospective cancers. Acta Oncol. 2007;46(3):286–307.CrossRefPubMedGoogle Scholar
  46. 46.
    Weinehall L, Hallgren CG, Westman G, Janlert U, Wall S. Reduction of selection bias in primary prevention of cardiovascular disease through involvement of primary health care. Scand J Prim Health Care. 1998;16(3):171–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Parr CL, Veierod MB, Laake P, Lund E, Hjartaker A. Test-retest reproducibility of a food frequency questionnaire (FFQ) and estimated effects on disease risk in the Norwegian Women and Cancer Study (NOWAC). Nutr J. 2006;5:4.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Hjartaker A, Andersen LF, Lund E. Comparison of diet measures from a food-frequency questionnaire with measures from repeated 24-hour dietary recalls. The Norwegian Women and Cancer Study. Public Health Nutr. 2007;10(10):1094–103.CrossRefPubMedGoogle Scholar
  49. 49.
    Johansson I, Hallmans G, Wikman A, Biessy C, Riboli E, Kaaks R. Validation and calibration of food-frequency questionnaire measurements in the Northern Sweden Health and Disease cohort. Public Health Nutr. 2002;5(3):487–96.CrossRefPubMedGoogle Scholar
  50. 50.
    Sheikh MA, Lund E, Braaten T. Test–retest reliability of self-reported diabetes diagnosis in the Norwegian Women and Cancer Study: a population-based longitudinal study (n = 33,919). SAGE Open Med. 2016;4:2050312115622857.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Skeie G, Mode N, Henningsen M, Borch KB. Validity of self-reported body mass index among middle-aged participants in the Norwegian Women and Cancer study. Clin Epidemiol. 2015;7:313–23.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Rylander C, Sandanger TM, Engeset D, Lund E. Consumption of lean fish reduces the risk of type 2 diabetes mellitus: a prospective population based cohort study of Norwegian women. PLoS ONE. 2014;9(2):e89845.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Statistik Sentralbyrå Informasjonstjeneste [Internet]. Uten kaffe stopper Norge. Statistics Norway. 2011 [cited 15 May 2017].

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Marko Lukic
    • 1
    • 4
    Email author
  • Lena Maria Nilsson
    • 2
  • Guri Skeie
    • 1
  • Bernt Lindahl
    • 3
  • Tonje Braaten
    • 1
  1. 1.Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsöNorway
  2. 2.Department of Public Health and Clinical Medicine, Nutritional ResearchUmeå UniversityUmeåSweden
  3. 3.Department of Public Health and Clinical Medicine, Occupational and Environmental MedicineUmeå UniversityUmeåSweden
  4. 4.Institutt for SamfunnsmedisinUiT Norges Arktiske UniversitetTromsöNorway

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