Coffee Consumption and Colorectal Cancer Survival: A Dose–Response Meta-analysis by Coffee Type and Disease Stage

BACKGROUND: Emerging evidence suggests that coffee consumption may improve colorectal cancer prognosis. However, its relevance with respect to dose-response, coffee type, and tumor stage remains unclear. METHODS: A systematic search was conducted in PubMed, EMBASE, and the Cochrane Library through May 31, 2025, to identify studies quantifying coffee intake among patients with colorectal cancer. Meta-analyses using random-effects models and dose-response analysis were performed to estimate hazard ratios (HR) for overall survival (OS), progression-free survival (PFS), and recurrence. Subgroup analyses were stratified by daily intake level, coffee type (caffeinated, decaffeinated, and total), and colorectal cancer stage. RESULTS: Four prospective cohort studies including 5,442 patients with colorectal cancer (53% male and 47% female) were analyzed with the following disease stage distribution: I (18%), II (18%), III (39%), IV (21%), and unspecified (4%). Coffee consumption was significantly associated with improved OS [HR, 0.78; 95% confidence interval (CI), 0.71-0.85], PFS (HR, 0.84; 95% CI, 0.74-0.94), and reduced recurrence (HR, 0.77; 95% CI, 0.66-0.91), showing a 4% reduction in hazard per additional cup per day across all outcomes. The strongest OS benefit was observed in stage III disease (HR, 0.57; 95% CI, 0.41-0.81), corresponding to a 10% reduction per cup. CONCLUSIONS: Coffee consumption is associated with improved survival and reduced recurrence in patients with colorectal cancer in a dose-dependent and stage-specific manner. IMPACT: This meta-analysis demonstrates stage- and type-specific survival benefits in colorectal cancer, which may inform more individualized dietary recommendations. It also underscores the need for validation in diverse cohorts and mechanistic studies.