多喝咖啡有助于提高结肠癌患者的存活率

Colon cancer patients who were heavy coffee drinkers had a far lower risk of dying or having their cancer return than those who did not drink coffee, with significant benefits starting at two to three cups a day, a new study found. Patients who drank four cups of caffeinated coffee or more a day had half the rate of recurrence or death than noncoffee drinkers.

一项新研究发现，与不喝咖啡的结肠癌患者相比，大量饮用咖啡的患者癌症复发或死亡的风险较低，而且从每天饮用咖啡两到三杯开始这种效益就十分显著。每天至少饮用四杯含咖啡因咖啡的患者的癌症复发或死亡率只有不喝咖啡者的一半。

But, the researchers caution, cancer patients should not start ordering extra tall coffees. The study, the first to report such findings, does not prove a cause-and-effect relationship between coffee drinking and a lower risk of colon cancer recurrence. As other experts note, there may be differences between heavy coffee drinkers and abstainers that the research was not able to account for.

不过，研究人员警告说，癌症患者不应因此就开始点超大杯的咖啡。该研究是对此类发现的首次报道，但未能证明饮用咖啡与较低的结肠癌复发风险之间的因果关系。正如其他专家所指出的那样，在大量饮用咖啡者与不喝咖啡者之间可能存在着该研究没有考虑到的差异。

In recent years, many studies have pointed to coffee’s health benefits, suggesting coffee may protect against Type 2 diabetes, reduce overall deaths and perhaps even help protect against dementia. Other studies have suggested coffee may reduce the risks of certain cancers, including colon cancer. The benefits are generally attributed to coffee’s antioxidant and anti-inflammatory properties. 

近年来，许多研究都指出咖啡具有健康效益，提出咖啡或可预防2型糖尿病，降低总体死亡率，甚至可能有助于防止痴呆症的发生。还有其它研究表明，咖啡可能会降低包括结肠癌在内的某些癌症的风险。这些优点通常都被归因于咖啡的抗氧化和抗炎特性。

But as with many studies about diet, proving a link between coffee consumption and protection against cancer recurrence is difficult. 

然而，关于饮食的研究虽多，要证实饮用咖啡与预防癌症复发之间的关联却十分困难。

“Think about it: People who drink a lot of coffee tend to be high stress, high pressure, intense and compulsive,” said Dr. Alfred Neugut, a professor of cancer research, medicine and epidemiology at Columbia University and a director of NewYork-Presbyterian Hospital’s Cancer Prevention Center. “If they have cancer, they’re going to be more obsessive about following all the rules and doing all the things they’re supposed to do. So it may be that coffee itself is playing a physiological role, but it may also be a surrogate marker for you being a compulsive health-conscious good behaver.” 

“想想看：大量喝咖啡的人往往压力比较大、容易紧张或有强迫倾向，”美国哥伦比亚大学(Columbia University)的癌症研究、医学和流行病学教授，纽约长老会医院(NewYork-Presbyterian Hospital)癌症防治中心(Cancer Prevention Center)的主任艾尔弗雷德·纽各特(Alfred Neugut)博士说。“如果他们患了癌症，肯定会更严格地遵循所有的规则，去做所有他们应该做的事情。因此，或许确实是咖啡本身发挥了什么生理作用，但也有可能爱喝咖啡只是特别注重健康行为的人们的一个替代性标识。”

Dr. Charles S. Fuchs, the director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who led the research, acknowledged the limitations of his study and called for interventional studies to replicate and confirm the findings.

该研究的负责人，波士顿市丹娜法伯癌症研究院(Dana-Farber Cancer Institute)胃肠道癌症中心(Gastrointestinal Cancer Center)的查尔斯·S·富克斯(Charles S. Fuchs)博士承认自己的研究存在局限性，并呼吁进行干预性研究以重现和证实这些结果。

“No one has ever done this before in colon cancer patients. It does require confirmation,” he said. Patients should not start drinking coffee based on this study, but, “If you’re a coffee drinker and enjoy your coffee, stick with it,” he said. “If a patient says, ‘Well I hate coffee,’ I’d say there are other things you can do, like avoid obesity, exercise regularly and follow a balanced diet.”

他说：“此前尚无人在结肠癌患者中进行过这样的研究。它确实需要经过确认。”富克斯博士还说，患者不宜因为这项研究就开始饮用咖啡，但是，“如果你本身就喝咖啡而且喜欢喝，不妨保持下去。“如果有患者说：‘我讨厌咖啡’，那我就会回答：还有很多其它的事情可以做，比方说避免肥胖、经常锻炼、均衡饮食等等。”

The study, published Monday in The Journal of Clinical Oncology, followed 953 patients with Stage 3 colon cancer who had been treated with surgery and chemotherapy.

这项研究发表在8月17日的《临床肿瘤学杂志》(The Journal of Clinical Oncology)上，共计随访了953名曾接受手术和化疗的3期结肠癌患者。

The patients, recruited from 1999 to 2001, were asked to fill out detailed dietary pattern questionnaires about food intake and lifestyle, first during chemotherapy and again six months later. The questionnaires asked about their intake of caffeinated or decaffeinated coffee, herbal and nonherbal tea, caffeinated soft drinks and chocolate.

研究人员于1999年至2001年期间招募了这些患者，并要求他们在化疗期间和六个月后分别填写了非常详细的关于饮食和生活方式的膳食结构调查问卷。问卷询问了他们饮用含咖啡因或无咖啡因咖啡、草药茶和不含草药的茶、含咖啡因的软饮料以及食用巧克力的情况。

The researchers adjusted the findings to control for differences such as gender, age, smoking, diet, caloric intake, consumption of sugar-sweetened beverages and alcohol, weight and physical activity. They did not, however, adjust for use of aspirin and other nonsteroidal anti-inflammatory drugs, even though their earlier work suggests such drugs may be protective against colon cancer recurrence. Dr. Fuchs said their previous research had not shown any association between coffee drinking and aspirin use. 

研究人员对初步结果进行了校正，以控制性别、年龄、吸烟、饮食、热量摄入、饮用含糖饮料和酒、体重和体育活动等差异。不过，他们并没有对阿司匹林和其它非甾体类抗炎药的使用情况进行校正，尽管他们此前的工作表明，这些药物或可预防结肠癌复发。富克斯博士称，他们之前的研究并未发现饮用咖啡与使用阿司匹林之间有任何关联。 

They determined that patients who had reported drinking four or more cups of caffeinated coffee a day were 52 percent less likely to have had a recurrence of cancer or to have died than those who had never drank coffee, while those who drank two to three cups of caffeinated coffee a day were 31 percent less likely than nondrinkers to have had a recurrence or to have died. Sweetened coffee beverages did not count.

他们的这项研究发现，较之从不饮用咖啡者，报告自己每天至少饮用四杯含咖啡因咖啡的患者癌症复发或死亡的可能性低了52%，而每天饮用两到三杯含咖啡因咖啡的患者癌症复发或死亡的可能性低了31%。上述数据未计入含糖咖啡饮料。

The researchers’ hypothesis is that the factors that increase risk for Type 2 diabetes, such as obesity, a sedentary lifestyle and high insulin levels, also drive colon cancer, Dr. Fuchs said. And many studies have shown that coffee consumption is associated with a lower risk for Type 2 diabetes, a chronic illness that may increase the risk of colon cancer. 

富克斯博士表示，他们研究人员的假设是，令2型糖尿病的风险增加的因素，如肥胖，久坐不动的生活方式和偏高的胰岛素水平等，也促发结肠癌。许多研究已经表明，饮用咖啡与较低的2型糖尿病风险相关，而2型糖尿病正是一种可能增加患结肠癌风险的慢性疾病。

“We believe that activating the energy pathways that contribute to heart disease and diabetes is also relevant for the proliferation of cancer cells,” Dr. Fuchs said, while also stressing that more research was needed.

富克斯博士说：“我们认为，能促发心脏病和糖尿病的能量转换途径与癌细胞的增殖也有关。”但他同时强调仍需要进行更多的研究。

The analysis determined the lowered risk associated with coffee was entirely because of the caffeine. One hypothesis is that caffeine increases the body’s sensitivity to insulin, so it requires less of the hormone. That, in turn, may reduce inflammation, which is a risk factor for diabetes and cancer.

这项分析确定了与咖啡相关的风险降低完全是咖啡因的功劳。一个假设是，咖啡因可增加人体对胰岛素的敏感性，减少需要的激素量。这相应地也会减少炎症——糖尿病和癌症的风险因素之一。

While there are inevitably gaps in these kinds of studies, the new research is “one piece of a big puzzle,” said Dr. Len Lichtenfeld, the deputy chief medical officer at the American Cancer Society, adding that there is tremendous concern about the role obesity and metabolic factors may play in promoting cancer.

美国癌症协会(American Cancer Society)的副首席医务官莱恩·利希滕费尔德(Len Lichtenfeld)博士表示，虽然此类研究中不可避免地还有着不少缺点，但这项新的研究毕竟为“解开大谜团提供了一条新的线索，他还说，人们对肥胖和代谢因素可能存在的促癌作用极其关注。

“This is an example of trying to look at those types of questions — about what the metabolic relationships are, and what might influence those metabolic relationships — in a positive way.”

“这是人们试图以积极的方式，探讨代谢关系、以及这些代谢关系可能造成的影响等问题的一个范例。”