已经患了乳腺癌,能否喝茶、喝咖啡
瑞典对参加钼靶筛查女性进行的大样本前瞻队列研究已经证实,乳腺癌诊断前咖啡和茶摄入量对乳腺癌相关死亡和全因死亡的影响不大。不过,乳腺癌诊断后咖啡和茶摄入量对乳腺癌相关死亡和全因死亡的影响尚不明确。
2021年3月24日,英国癌症研究基金会《英国癌症杂志》在线发表美国哈佛大学陈曾熙公共卫生学院、哈佛大学医学院、布莱根医院和波士顿妇女医院、加拿大多伦多大学的史诗级研究报告,调查了乳腺癌诊断后咖啡和茶摄入量对乳腺癌相关死亡和全因死亡的影响。
该大样本前瞻队列研究对1980~2010年参加护士健康研究的12万1700位女性、1991~2011年参加护士健康研究二期的11万6429位女性进行随访,其中诊断早期乳腺癌女性8900例。随后,根据乳腺癌诊断后每4年1次食物频次问卷调查,对乳腺癌诊断后咖啡和茶摄入量进行定量分析。
令人叹为观止的是,为了减少其他因素的影响,该研究还对每位乳腺癌女性所喝咖啡的卡路里、乳腺癌诊断时的年龄和年份、乳腺癌诊断至问卷调查的时间长短、问卷调查的年份、乳腺癌诊断前的体重指数和口服避孕药、乳腺癌诊断后的体重指数变化、体力活动量、阿司匹林用量、吸烟、酒精摄入量、卡路里总摄入量、绝经状态、绝经年龄、激素补充情况、种族、肿瘤分期、雌激素和孕激素状态、放疗、化疗、内分泌治疗等其他影响因素进行了校正。
由于研究对象全部为美国女性注册护士,也大大减少了问卷调查的难度和失访率,大大提高了问卷调查结果的准确性和可信度。
结果,经过长达30年随访,发生乳腺癌相关死亡1054例、全因死亡2501例。
与不喝咖啡者相比:
每天喝咖啡1杯:乳腺癌相关死亡风险相似(校正后风险比:0.99,95%置信区间:0.82~1.20)
每天喝咖啡2杯:乳腺癌相关死亡风险相似(校正后风险比:1.09,95%置信区间:0.88~1.36)
每天喝咖啡3杯:乳腺癌相关死亡风险相似(校正后风险比:0.83,95%置信区间:0.67~1.02)
每天喝咖啡>3杯:乳腺癌相关死亡风险低25%(校正后风险比:0.75,95%置信区间:0.59~0.96,趋势分析P=0.002)
每天喝咖啡1杯:全因死亡风险相似(校正后风险比:0.96,95%置信区间:0.84~1.09)
每天喝咖啡2杯:全因死亡风险相似(校正后风险比:1.03,95%置信区间:0.89~1.19)
每天喝咖啡3杯:全因死亡风险低24%(校正后风险比:0.76,95%置信区间:0.66~0.87)
每天喝咖啡>3杯:全因死亡风险低26%(校正后风险比:0.74,95%置信区间:0.63~0.87,趋势分析P<0.0001)
与不喝茶者相比:
每天喝茶1杯:乳腺癌相关死亡风险相似(校正后风险比:0.94,95%置信区间:0.81~1.10)
每天喝茶2杯:乳腺癌相关死亡风险相似(校正后风险比:1.04,95%置信区间:0.82~1.31)
每天喝茶3杯:乳腺癌相关死亡风险相似(校正后风险比:0.83,95%置信区间:0.64~1.08)
每天喝茶>3杯:乳腺癌相关死亡风险相似(校正后风险比:0.80,95%置信区间:0.56~1.14,趋势分析P=0.17)
每天喝茶1杯:全因死亡风险相似(校正后风险比:0.92,95%置信区间:0.83~1.02)
每天喝茶2杯:全因死亡风险相似(校正后风险比:1.00,95%置信区间:0.86~1.17)
每天喝茶3杯:全因死亡风险相似(校正后风险比:0.85,95%置信区间:0.71~1.01)
每天喝茶>3杯:全因死亡风险低26%(校正后风险比:0.74,95%置信区间:0.58~0.95,趋势分析P=0.04)
编者按:美制标准1杯等于8盎司或1/2品脱,相当于公制227.3毫升。
因此,该大样本前瞻队列研究长期随访结果表明,对于美国早期乳腺癌女性护士而言,乳腺癌诊断后喝咖啡较多与从不喝咖啡者相比,乳腺癌相关生存和总生存结局较好;乳腺癌诊断后喝茶较多与不喝茶者相比,总生存结局可能较好;故有必要开展进一步研究,对中国乳腺癌女性进行验证。
相关链接
Br J Cancer. 2021 Mar 24. Online ahead of print.
Post-diagnostic coffee and tea consumption and breast cancer survival.
Maryam S. Farvid, Nicholas D. Spence, Bernard A. Rosner, Walter C. Willett, A. Heather Eliassen, Michelle D. Holmes.
Harvard T.H. Chan School of Public Health, Boston, MA, USA; Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; University of Toronto, Toronto, ON, Canada.
BACKGROUND: We examined the role of post-diagnostic coffee and tea consumption in relation to breast cancer-specific and all-cause mortality among women with breast cancer in prospective cohort studies.
METHODS: We identified 8900 women with stage I-III breast cancer from 1980 through 2010 in the Nurses' Health Study (NHS) and from 1991 through 2011 in the NHSII. Post-diagnostic coffee and tea consumption was assessed by a validated food frequency questionnaire every 4 years after diagnosis.
RESULTS: During up to 30 years of follow-up, we documented 1054 breast cancer-specific deaths and 2501 total deaths. Higher post-diagnostic coffee consumption was associated with a lower breast cancer-specific mortality: compared with non-drinkers, >3 cups/day of coffee was associated with a 25% lower risk (hazard ratio (HR)=0.75, 95% confidence interval (CI)=0.59-0.96; Ptrend=0.002). We also observed a lower all-cause mortality with coffee consumption: compared with non-drinkers, >2 to 3 cups/day was associated with a 24% lower risk (HR=0.76, 95% CI=0.66-0.87) and >3 cups/day was associated with a 26% lower risk (HR=0.74, 95% CI=0.63-0.87, Ptrend<0.0001). Post-diagnostic tea consumption was associated with a lower all-cause mortality: compared with non-drinkers, >3 cups/day was associated with a 26% lower risk (HR=0.74, 95% CI=0.58-0.95; Ptrend=0.04).
CONCLUSIONS: Among breast cancer survivors, higher post-diagnostic coffee consumption was associated with better breast cancer and overall survival. Higher post-diagnostic tea consumption may be related to better overall survival.
DOI: 10.1038/s41416-021-01277-1