With nearly 77,000 new cases and 9,500 deaths in 2013, cutaneous melanoma is the 5th most common cancer and the leading cause of skin cancer death in the US. Modifiable risk factors, with the exception of exposure to ultraviolet (UV) radiation, are poorly understood. Coffee contains numerous bioactive compounds and may be associated inversely with melanoma. However, epidemiological evidence is limited to a few case-control and prospective cohort studies with inconsistent results. To better understand this association, we analyzed data from the large, prospective NIH-AARP Study. Coffee intake was assessed at baseline with a food frequency questionnaire. Among 447,357 non-Hispanic whites who were cancer-free at baseline, 2,904 incident cases of melanoma were identified by linkage between NIH-AARP cohort membership and 11 state cancer registries during 4,329,044 person years of follow up. Respondents were followed from baseline until the date of first skin cancer diagnosis, the date of death, the end of study follow-up (December 31, 2006), or the date the subject moved out of the registry ascertainment area, whichever came first. We used Cox proportional hazards models adjusted for multiple potential confounders to estimate hazard ratios (HR) and 95% confidence intervals (CI) for melanoma risk in relation to level of coffee intake. Increasing coffee intake was inversely associated with risk of melanoma (p-trend = 0.013), and those who consumed ≥4 cups/d had a 20% reduction in the risk of melanoma compared to those who consumed no coffee. This association was significant for caffeinated coffee (≥4 vs. 0 cups/d: HR=0.75, 95% CI=0.64-0.89; p-trend = 0.008) but was not observed for decaffeinated coffee (≥4 vs. 0 cups/d: HR=0.95, 95% CI=0.76-1.18; p-trend = 0.55). Coffee intake was inversely associated with melanoma risk in this large US cohort study. Additional investigations of coffee intake and its constituents, particularly caffeine, in the prevention of melanoma are warranted.

Table.

Association of Daily Coffee Consumption with Melanoma

 Total Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 310 942 1253 399 – 
Age & sex-adjusted HR (95% CI) 1.00 0.90 (0.80-1.03) 0.88 (0.78-1.00) 0.72 (0.62-0.83) <0.0001 
Multivariate adjusted HR (95% CI)1 1.00 0.91 (0.80-1.04) 0.90 (0.80-1.28) 0.80 (0.68-0.93) 0.013 
 Caffeinated Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 1,300 461 862 281 – 
Age & sex-adjusted HR (95% CI) 1.00 0.88 (0.77-1.02) 0.88 (0.78-1.01) 0.67 (0.57-0.79) <0.0001 
Multivariate adjusted HR (95% CI)2 1.00 0.89 (0.77-1.03) 0.91 (0.80-1.04) 0.75 (0.64-0.89) 0.008 
 Decaffeinated Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 2,010 428 359 107 – 
Age & sex-adjusted HR (95% CI) 1.00 0.92 (0.79-1.06) 0.88 (0.76-1.03) 0.88 (0.71-1.0) 0.160 
Multivariate adjusted HR (95% CI)3 1.00 0.92 (0.79-1.06) 0.90 (0.77-1.05) 0.95 (0.76-1.18) 0.549 
 Total Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 310 942 1253 399 – 
Age & sex-adjusted HR (95% CI) 1.00 0.90 (0.80-1.03) 0.88 (0.78-1.00) 0.72 (0.62-0.83) <0.0001 
Multivariate adjusted HR (95% CI)1 1.00 0.91 (0.80-1.04) 0.90 (0.80-1.28) 0.80 (0.68-0.93) 0.013 
 Caffeinated Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 1,300 461 862 281 – 
Age & sex-adjusted HR (95% CI) 1.00 0.88 (0.77-1.02) 0.88 (0.78-1.01) 0.67 (0.57-0.79) <0.0001 
Multivariate adjusted HR (95% CI)2 1.00 0.89 (0.77-1.03) 0.91 (0.80-1.04) 0.75 (0.64-0.89) 0.008 
 Decaffeinated Coffee Intake p-trend 
 None (Ref.) ≤1 cup/d 2-3 cups/d ≥4 cups/d  
No. cases 2,010 428 359 107 – 
Age & sex-adjusted HR (95% CI) 1.00 0.92 (0.79-1.06) 0.88 (0.76-1.03) 0.88 (0.71-1.0) 0.160 
Multivariate adjusted HR (95% CI)3 1.00 0.92 (0.79-1.06) 0.90 (0.77-1.05) 0.95 (0.76-1.18) 0.549 

1Adjusted for age, sex, cigarette smoking (detailed), cigar/pipe smoking, BMI, education, average daily alcohol intake, physical activity, family history of cancer, July erythemal exposure

2Adjusted for age, sex, cigarette smoking (detailed), cigar/pipe smoking, BMI, education, average daily alcohol intake, physical activity, family history of cancer, July erythemal exposure, and decaffeinated coffee intake

3Adjusted for age, sex, cigarette smoking (detailed), cigar/pipe smoking, BMI, education, average daily alcohol intake, physical activity, family history of cancer, July erythemal exposure, and caffeinated coffee intake

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Citation Format: Erikka Loftfield, Susan Mayne, Fatma Shebl, Neal Freedman, Barry Graubard, Rashmi Sinha. Prospective study of coffee drinking and risk of melanoma in the United States. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-280. doi:10.1158/1538-7445.AM2014-LB-280

©2014 American Association for Cancer Research.
2014