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Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case–control study

Ferrucci, Leah M.a,b; Cartmel, Brendaa,b; Molinaro, Annette M.a,b,e,f; Leffell, David J.b,c; Bale, Allen E.b,d; Mayne, Susan T.a,b

European Journal of Cancer Prevention: July 2014 - Volume 23 - Issue 4 - p 296–302
doi: 10.1097/CEJ.0000000000000037
Research Papers: Skin Cancer

Tea and coffee are hypothesized to play a protective role in skin carcinogenesis through bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data support an inverse association with basal cell carcinoma (BCC), more so than for melanoma or squamous cell carcinoma. To understand whether tea, coffee, and caffeine are related to early-onset BCC, we evaluated data from 767 non-Hispanic Whites under age 40 in a case–control study in Connecticut. BCC cases (n=377) were identified through Yale’s Dermatopathology database. Controls (n=390) were randomly sampled from individuals in the same database with benign skin diagnoses and frequency matched to cases on age, sex, and biopsy site. Participants completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Combined regular consumption of caffeinated coffee plus hot tea was inversely associated with early-onset BCC (OR=0.60, 95% CI=0.38–0.96). Those in the highest category of caffeine from these sources had a 43% reduced risk of BCC compared with nonconsumers (OR=0.57, 95% CI=0.34–0.95, P-trend=0.037). Our findings suggest a modest protective effect for caffeinated coffee plus tea in relation to early-onset BCC that may, in part, be due to caffeine. This study adds to the growing body of literature suggesting potential health benefits from these beverages.

aDepartments of Chronic Disease Epidemiology and Biostatistics, Yale School of Public Health

bYale Cancer Center

cDepartments of Dermatology and Surgery

dDepartment of Genetics, Yale University School of Medicine, New Haven, Connecticut

eDepartment of Neurological Surgery

fDepartment of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, California, USA

Correspondence to Leah M. Ferrucci, PhD, MPH, Yale School of Public Health, 55 Church Street, Suite 801, New Haven, CT 06510, USA Tel: +1 203 764 9088; fax: +1 203 764 5824; e-mail:

Received July 15, 2013

Accepted August 23, 2013

© 2014 Lippincott Williams & Wilkins, Inc.