title: Association of coffee intake with reduced incidence of liver cancer and death from chronic liver disease in the US multiethnic cohort.
abstract: OBJECTIVE
  Coffee consumption has been proposed to reduce risk for hepatocellular carcinoma (HCC) and chronic liver disease (CLD), but few data are available from prospective, US multiethnic populations. We evaluated the association of coffee intake with HCC and CLD in 162,022 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the US Multiethnic Cohort (MEC).
  
  
  METHODS
  We collected data from the MEC, a population-based prospective cohort study of >215,000 men and women from Hawaii and California, assembled in 1993-1996. Participants reported coffee consumption and other dietary and lifestyle factors when they joined the study. During an 18-year follow-up period, there were 451 incident cases of HCC and 654 deaths from CLD. Hazard rate ratios (RRs) and 95% confidence intervals (CIs) were calculated using Cox regression, adjusting for known HCC risk factors.
  
  
  RESULTS
  High levels of coffee consumption were associated with reduced risk of incident HCC and CLD mortality (Ptrend ≤ .0002). Compared with non-coffee drinkers, those who drank 2-3 cups per day had a 38% reduction in risk for HCC (RR = 0.62; 95% CI: 0.46-0.84); those who drank ≥4 cups per day had a 41% reduction in HCC risk (RR = 0.59; 95% CI: 0.35-0.99). Compared with non-coffee drinkers, participants who consumed 2-3 cups coffee per day had a 46% reduction in risk of death from CLD (RR = 0.54; 95% CI: 0.42-0.69) and those who drank ≥4 cups per day had a 71% reduction (RR = 0.29; 95% CI: 0.17-0.50). The inverse associations were similar regardless of the participants' ethnicity, sex, body mass index, smoking status, alcohol intake, or diabetes status.
  
  
  CONCLUSIONS
  Increased coffee consumption reduces the risk of HCC and CLD in multiethnic US populations.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. Electronic address: vsetiawa@usc.edu.
authors.forename: Veronica Wendy
authors.initials: VW
authors.lastname: Setiawan
authors.affiliation: Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.affiliation: Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Shelly C
authors.initials: SC
authors.lastname: Lu
authors.affiliation: Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.affiliation: Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Marchand
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Henderson
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D002140:California / Q000453:epidemiology; D002423:Cause of Death; D002908:Chronic Disease; D003069:Coffee; D005006:Ethnicity; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008019:Life Style / Q000208:ethnology; D016013:Likelihood Functions; D008107:Liver Diseases / Q000208:ethnology* / Q000401:mortality / Q000517:prevention & control; D008113:Liver Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors
chemical_list: D003069:Coffee
keywords: Epidemiology; Liver Cancer; Protective; Race