ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Coffee Drinkers May be at a Lower Risk of Getting Oral Cancers
Clinical Question In a group of healthy patients, do coffee drinkers compared to non-coffee drinkers have a lowered risk of getting oral cancer?
Clinical Bottom Line Coffee may decrease the risk of acquiring oral cancer in an otherwise healthy individual.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12907209Tavani/2003 634 males and 115 females ages 50-70s and 1772 controls.Hospital based case-control study
Key resultsA case-controlled study of 2521 individuals was performed over the course of six years. An inverse trend in risk was found between coffee consumption and oral cancer, meaning those who consumed coffee had oral cancer less often than those who did not consume coffee. The measure of association between coffee consumption and oral cancer, also known as the odds ratio, for more than 3 cups of coffee per day verses less than one cup of coffee per day was 0.6 for males and 0.8 for females. The likelihood that the results were not due to chance, or the confidence interval, for these subjects was 95%.
Evidence Search (("Coffee"[Mesh] AND "Risk"[Mesh]) AND "Pharyngeal Neoplasms"[Mesh]) AND "Mouth Neoplasms"[Mesh]
Comments on
The Evidence
Validity: The groups were similar at the beginning and were all treated the same with had adequate follow ups. This was not a double-blind study. However, being a case-controlled (retrospective) study, the level of evidence is low. Compliance of the patients was adequate, with only about 5-15% refusal. The patients were interviewed about their dietary habits in the previous two years, so a recall bias could be likely. No competing interests were evident. Perspective: Traditionally the risk factors for developing oral squamous cell carcinoma (OSCC) include tobacco use, alcohol consumption, sun exposure, and advanced age. While this study is interesting it neglects an emerging change in risk factors for developing oral squamous cell carcinoma (OSCC), namely the startling increase in Human Papilloma Virus (HPV) related disease in individuals that otherwise have no known risk factors. Clinically we are seeing younger patients with no history of tobacco or alcohol use who develop OSCC due to HPV infection. This is an important distinction because HPV related disease responds much more favorably to therapy and it dramatically changes the way clinicians must view the need for routine oral cancer screening. Now we must evaluate every patient on a regular basis because age and history of smoking or alcohol use are no longer key players in new cases of OSCC. In fact OSCC related to tobacco and alcohol use are dramatically on the decline as HPV related cancers are steadily increasing. While coffee consumption may prove to be protective it would be interesting to evaluate the change in risk in relation to HPV associated OSCC.
Applicability Because the inverse trend between coffee consumption and oral cancer was seen in all groups, regardless of smoking habits, alcohol consumption, and fruit and vegetable intake, this evidence is applicable to most normal, healthy patients.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery)
Keywords Oral cancer; coffee; pharyngeal cancer
ID# 2384
Date of submission: 02/28/2013spacer
E-mail BhaktaP@livemail.UTHSCSA.edu
Author Puja J. Bhakta
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Cara Gonzales, DDS, PhD
Faculty mentor/Co-author e-mail GonzalesC5@UTHSCSA.edu
Basic Science Rationale
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