Risk of pancreatic cancer among heavy coffee drinkers and the “overall” risk

As mentioned in our paper2 (Introduction, second paragraph), the epidemiological evidence certainly includes the possibility that the risk of exocrine pancreatic cancer is slightly increased among people drinking large amounts of coffee. This conclusion has been achieved by several reviews of the literature and one meta-analysis.2 Figure 1 of Kuperet al is in line with such possibility. How much could “large amounts” be? It is hard to say, mostly because the actual composition of the beverage varies so much across countries, as do probably a number of factors with which coffee interacts to cause the increased risk. Specific studies are needed to clarify these issues, as we shall see immediately.

In principle, the previous sentences are compatible with another conclusion, which we consider fairly well established and that we also share with our colleagues1: the epidemiological evidence indicates that no overall association exists between coffee drinking and risk of exocrine pancreatic cancer (Introduction, second paragraph; Discussion, third paragraph).2 In table 1, we now present adjusted odds ratios for the entire group of 107 cases of pancreatic cancer, as compared with the three referent groups that our original paper mentioned (Discussion, second and third paragraphs).2 As can be seen (table 1, first and second columns), the overall risk estimates are very close to …