Joint effects of coffee consumption and serum gamma-glutamyltransferase on the risk of liver cancer

Authors

  • Gang Hu,

    Corresponding author
    1. Department of Public Health, University of Helsinki, Helsinki, Finland
    2. Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland
    • Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland
    Search for more papers by this author
    • fax: +358 9 19127313.

  • Jaakko Tuomilehto,

    1. Department of Public Health, University of Helsinki, Helsinki, Finland
    2. Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland
    3. South Ostrobothnia Central Hospital, Seinäjoki, Finland
    Search for more papers by this author
  • Eero Pukkala,

    1. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
    Search for more papers by this author
  • Timo Hakulinen,

    1. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
    Search for more papers by this author
  • Riitta Antikainen,

    1. Oulu City Hospital, Oulu, Finland
    Search for more papers by this author
  • Erkki Vartiainen,

    1. Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland
    Search for more papers by this author
  • Pekka Jousilahti

    1. Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland
    Search for more papers by this author

  • Potential conflict of interest: Nothing to report.

Abstract

Only three Japanese prospective studies have suggested an inverse association between coffee drinking and liver cancer risk. No prospective studies on the association between serum gamma-glutamyltransferase (GGT) and liver cancer risk have been reported. We aimed to determine the single and joint associations of coffee consumption and serum GGT with the risk of primary liver cancer. Study cohorts included 60,323 Finnish participants who were 25-74 years of age and free of any cancer at baseline. During a median follow-up period of 19.3 years (interquartile range: 9.3-29.2 years), 128 participants were diagnosed with an incident liver cancer. The multivariable-adjusted (age, sex, alcohol consumption, education, smoking, diabetes and chronic liver disease at baseline and during follow-up, and body mass index) hazards ratios of liver cancer in participants who drank 0-1, 2-3, 4-5, 6-7, and ≥8 cups of coffee daily were 1.00, 0.66, 0.44, 0.38, and 0.32 (P for trend = 0.003), respectively. Further adjustment for serum GGT in subgroup analysis affected the results only slightly. The multivariable-adjusted and coffee-adjusted hazard ratio of liver cancer for the highest versus the lowest quartile of serum GGT was 3.13 (95% confidence interval = 1.22-8.07). The multivariable-adjusted inverse association between coffee consumption and liver cancer risk persisted when stratified by baseline factors: age more/less than 50 years, current smoker/never smoked/ever smoked, alcohol drinker/never drinker, obese/nonobese, and the highest/lowest three quartiles of serum GGT. A combination of very low coffee consumption and high level of serum GGT was associated with nearly nine-fold increased risk. Conclusion: Coffee drinking has an inverse and graded association with the risk of liver cancer. High serum GGT is associated with an increased risk of liver cancer. (HEPATOLOGY 2008.)

Ancillary