title: Coffee intake and gastric cancer risk: the Singapore Chinese health study.
abstract: BACKGROUND
  Despite experimental evidence showing chemopreventive effects of coffee-related compounds on gastric carcinogenesis, epidemiologic studies generally do not support coffee-gastric cancer associations. Observational data are lacking among high-risk populations with sufficient regular coffee consumption.
  
  
  METHODS
  We examined the association between caffeinated coffee intake and gastric cancer risk in a population-based cohort that enrolled 63,257 Chinese men and women ages 45 to 74 years between 1993 and 1998 in Singapore. Incident gastric cancer cases (n = 647) were identified after a mean follow-up of 14.7 years. Biomarkers of Helicobacter pylori (H. pylori) infection were measured in a subset of gastric cancer cases with blood collected before cancer diagnosis and their matched controls.
  
  
  RESULTS
  In the total cohort, daily versus nondaily coffee intake was associated with a statistically nonsignificant decrease in gastric cancer risk [HR = 0.85; 95% confidence interval (CI), 0.69-1.04]. In women, the inverse association strengthened and reached statistical significance (HR = 0.63; 95% CI, 0.46-0.87). In analyses restricted to never smokers and nondrinkers of alcohol, inverse associations strengthened in the total cohort (HR = 0.69; 95% CI, 0.52-0.91) and in women (HR = 0.52; 95% CI, 0.37-0.74). There was no coffee-gastric cancer risk association among men, regardless of smoking status or alcohol consumption. Similar results were observed in the nested case-control study after adjustment for H. pylori infection.
  
  
  CONCLUSIONS
  Daily coffee consumption may reduce the risk of gastric cancer in high-risk populations, especially among women.
  
  
  CONCLUSIONS
  Research aimed at identifying the compounds in coffee that may protect against gastric carcinogenesis is warranted.
authors.affiliation: Authors' Affiliations: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis; Department of Food Science and Nutrition, University of Minnesota, Saint Paul, Minnesota; Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Duke-NUS Graduate Medical School Singapore, Singapore; Saw Swee Hock School of Public Health and Department of Medicine, National University of Singapore, Singapore; National Registry of Diseases Office, Health Promotion Board; and Department of Gastroenterology and Hepatology, National University Health System, Singapore.
authors.forename: Cheryl E
authors.initials: CE
authors.lastname: Ainslie-Waldman
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.forename: Aizhen
authors.initials: A
authors.lastname: Jin
authors.forename: Khay Guan
authors.initials: KG
authors.lastname: Yeoh
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.forename: Renwei
authors.initials: R
authors.lastname: Wang
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Butler
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003069:Coffee; D015331:Cohort Studies; D004327:Drinking Behavior; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012846:Singapore; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D003069:Coffee