Drinking coffee appears to confer survival gains and reduce the risk of recurrence in patients with colorectal cancer (CRC), according to a meta-analysis.
Pooled data from four prospective cohort studies showed that compared with abstainers, coffee drinkers had a 22-percent lower risk of death (overall survival [OS]: hazard ratio [HR], 0.78, 95 percent confidence interval [CI], 0.71–0.85; I²=22.3 percent) and 16-percent reduced risk of progression or death (progression-free survival [PFS]: HR, 0.84, 95 percent CI, 0.74–0.94; I²=18.6 percent). [Cancer Epidemiol Biomarkers Prev 2026;35:447-455]
Moreover, the risk of recurrence decreased by 23 percent among coffee drinkers vs abstainers (HR, 0.77, 95 percent CI, 0.66–0.91; I² 0 percent).
“A clear linear dose–response relationship was observed for these three outcomes, with approximately a 4-percent reduction in hazard per additional cup consumed daily,” the authors noted.
Additional analyses by type of coffee indicated that both caffeinated and decaffeinated coffee had similar beneficial effects on OS and PFS. On the other hand, notable trends emerged on stage-stratified analyses.
For instance, the improvement in OS associated with coffee consumption was most pronounced in stage III CRC, with a 43-percent reduction in the risk of death relative to abstinence (HR, 0.57, 95 percent CI, 0.41–0.81). This association followed a significant linear dose-response trend, such that the risk dropped by 10 percent for every cup of coffee consumed daily (HR, 0.90, 95 percent CI, 0.87–0.93; p<0.0001 for trend).
Meanwhile, the OS benefit with coffee consumption was attenuated in stage IV CRC (HR, 0.57, 95 percent CI, 0.41–0.81) and disappeared in stages I/II (HR, 0.89, 95 percent CI, 0.76–1.05).
“Although the underlying mechanisms are unclear, the notably strong association in stage III may suggest coffee’s antimetastatic properties, considering that the survival rates of CRC decline sharply once distant metastasis occurs, particularly in the presence of liver metastases,” the authors explained. “For patients with stage IV disease, this effect may have been limited by established metastases, resulting in a weaker association.”
On the other hand, the null association observed in earlier CRC stages may be attributed to the relatively low 5-year recurrence rates of 7 percent and 12 percent for stages I and II, respectively, across the included studies, according to the authors. Furthermore, the median follow-up durations of 5.4–7.8 years may have been insufficient to capture late recurrences, they added.
Taken together, the findings highlight the potential of coffee drinking as a beneficial lifestyle factor in CRC survivorship, the authors said. The data can help inform more individualized dietary recommendations and stage-specific survivorship care strategies.
The four prospective cohort studies included in the meta-analysis involved 5,442 patients (53 percent male) with CRC. Disease stage was I in 18 percent, II in 18 percent, III in 39 percent, IV in 21 percent, and unspecified in 4 percent.