title: Coffee drinking and hepatocellular carcinoma risk: a meta-analysis.
abstract: Several studies suggest an inverse relation between coffee drinking and risk of hepatocellular carcinoma (HCC). We conducted a meta-analysis of published studies on HCC that included quantitative information on coffee consumption. Ten studies were retrieved (2,260 HCC cases), including 6 case-control studies from southern Europe and Japan (1551 cases) and 4 cohort studies from Japan (709 cases). The summary relative risk (RR) for coffee drinkers versus non-drinkers was 0.54 (95% confidence interval [CI] 0.38-0.76) for case-control studies and 0.64 (95% CI 0.56-0.74) for cohort studies. The overall RR was 0.59 (95% CI 0.49-0.72), with significant heterogeneity between studies. The overall summary RR for low or moderate coffee drinkers was 0.70 (95% CI 0.57-0.85), and that for high drinkers was 0.45 (95% CI 0.38-0.53). The summary RR for an increase of 1 cup of coffee per day was 0.77 (95% CI 0.72-0.83) from case-control studies, 0.75 (95% CI 0.65-0.85) from cohort studies, and 0.77 (95% CI 0.72-0.82) overall. The consistency of an inverse relation between coffee drinking and HCC across study design and geographic areas weighs against a major role of bias or confounding. Coffee drinking has also been related to reduced risk of other liver diseases, thus suggesting a continuum of the favorable effect of coffee on liver function. However, subjects with liver conditions may selectively reduce their coffee consumption.
  
  
  CONCLUSIONS
  The present analysis provides evidence that the inverse relation between coffee and HCC is real, though inference on causality remains open to discussion.
authors.affiliation: Laboratorio di Epidemiologia, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. bravi@marionegri.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Bravi
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosetti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tavani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
authors.forename: Silvano
authors.initials: S
authors.lastname: Gallus
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000517:prevention & control*; D016022:Case-Control Studies; D003069:Coffee; D006801:Humans; D008113:Liver Neoplasms / Q000517:prevention & control*
chemical_list: D003069:Coffee