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Data from a large Italian case-control study confirm that the tobacco related relative risk of bladder cancer is higher in coffee non-drinkers than in coffee drinkers. However, given the correlation between tobacco and coffee, the population attributable risk was similar for coffee drinkers and non-drinkers.
Lopez-Abente and Escolar, using data from a Spanish case-control study, suggested that the association between tobacco smoking and bladder cancer may be stronger among coffee non-drinkers than among usual coffee drinkers.1 This potential favourable interaction has some biological plausibility, and can be related to the inhibition of enzymes involved in the activation of carcinogenic aromatic amines, including cytochrome P4501A2.2
To provide further information on the issue, we analysed data from a case-control study conducted in Italy between 1985 and 1992, whose main results on tobacco and coffee have been published elsewhere.3,4 Briefly, a total of 727 …