Coffee consumption and risk of colorectal cancer in the Cancer Prevention Study-II Nutrition Cohort

Cancer Epidemiol. 2020 Aug:67:101730. doi: 10.1016/j.canep.2020.101730. Epub 2020 Jun 9.


Background: The association between coffee consumption and colorectal cancer risk generally appears null, but recent evidence suggests that risk may vary by coffee type. We examined associations of caffeinated and decaffeinated coffee intake with colorectal cancer risk overall and with colon and rectum separately, among older U.S. men and women.

Methods: In 1999, 47,010 men and 60,051 women with no previous diagnosis of cancer, aged 47-96 years, in the Cancer Prevention Study-II Nutrition Cohort completed a food frequency questionnaire that assessed caffeinated and decaffeinated coffee intake; consumption was updated in 2003. A total of 1829 colorectal cancer cases were verified through June 2015. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard rate ratios (HRs) and 95% confidence intervals (CIs), adjusting for smoking history, alcohol, caffeinated/decaffeinated coffee intake (depending on the model), and other colorectal cancer risk factors.

Results: Consumption of ≥2 cups/day of decaffeinated coffee, compared to no decaffeinated coffee, was associated with lower risk of overall colorectal cancer (HR = 0.82, 95% CI: 0.69-0.96, P-trend = 0.04), colon cancer (HR = 0.82, 95% CI: 0.69-0.99, P-trend = 0.05) and rectal cancer (HR = 0.63, 95% CI: 0.40-0.99, P-trend = 0.17). Consumption of ≥2 cups/day of caffeinated coffee was associated with higher risk of rectal cancer (HR = 1.37, 95% CI: 0.99-1.89, P-trend = 0.04), but not with colorectal or colon cancer.

Conclusion: In this prospective study, higher intake of decaffeinated coffee was associated with lower risk of colorectal, colon, and rectal cancers. Further study on associations of caffeinated and decaffeinated coffee with colorectal cancer risk by subsite is needed.

Keywords: Caffeine; Coffee; Cohort study; Colorectal cancer; Colorectal subsite.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Caffeine / administration & dosage
  • Caffeine / adverse effects*
  • Coffee / adverse effects*
  • Colorectal Neoplasms / etiology*
  • Colorectal Neoplasms / prevention & control
  • Female
  • Humans
  • Male
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires


  • Coffee
  • Caffeine