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In 1991, coffee was placed under a cloud of suspicion. The International Agency for Research on Cancer (IARC), part of the World Health Organization, classified coffee as “possibly carcinogenic to humans”. This categorisation was based on early research that drew associations between coffee and bladder cancer, supported by animal studies and human case-control studies. At the time, these studies looked backwards, analysing people who already had cancer and comparing their lifestyle habits, including coffee consumption, to those who did not.
These early findings were far from conclusive. Case-control studies are vulnerable to significant biases, and in the absence of large-scale, long-term data, suspicions about coffee lingered. Coffee lovers around the world were left uncertain, and a morning ritual that had been practised for centuries suddenly seemed dangerous.
The classification was especially striking because coffee had long been associated with energy, productivity and even social connection. To think of it as a potential carcinogen shook public trust and fuelled health debates for decades.
The shift to long-term evidence
Science advances not through snapshots but through observation over time. What researchers lacked in 1991 were prospective studies long-term investigations following large groups of cancer-free individuals, tracking their coffee habits, and observing how many eventually developed cancer.
Over the next 30 years, this kind of evidence began to accumulate. By the mid-2000s and especially by 2016, when IARC revisited its assessment with more than 1,000 studies, the narrative had changed completely. Coffee was no longer considered “possibly carcinogenic”. Instead, the data suggested that coffee might reduce the risk of several cancers, shifting it from suspect to protector.
Coffee’s protective effect on cancer
The combined data from large prospective studies revealed an overall reduction of around 18% in cancer risk among coffee drinkers compared with non-drinkers. The evidence was strongest for two types of cancer: liver cancer and endometrial cancer.
Coffee and liver cancer
Liver cancer, one of the most deadly and difficult-to-treat cancers, showed one of the most consistent associations. Each daily cup of coffee was linked to roughly a 15% lower risk, with high coffee consumption leading to a 50% reduction in risk compared to little or no intake. This protective effect seems linear up to about five or six cups per day.
The mechanism is linked to coffee’s impact on insulin resistance, inflammation and fat accumulation in the liver. Coffee drinkers have also been shown to have lower risks of liver fibrosis and cirrhosis, conditions that are known to progress to liver cancer. In short, coffee appears to be good for liver health overall.
Coffee and endometrial cancer
Endometrial cancer, affecting the lining of the uterus, also shows a strong protective relationship with coffee. Like liver cancer, the benefits appear to rise with higher consumption up to about six cups daily. Coffee’s influence on hormones and metabolic function is believed to play a role in this protection.
Other cancers and coffee
For colorectal cancer, studies suggest a modest reduction in risk, potentially due to coffee’s effect on bowel movements and reduced contact time between carcinogens and the intestinal lining. Prostate cancer has also been linked to about a 9–10% lower risk among coffee drinkers, while some studies suggest a similar protective effect against skin cancer, particularly melanoma, possibly due to coffee’s antioxidant compounds.
For breast cancer, the overall effect appears neutral, though some studies suggest a protective effect in post-menopausal women, possibly linked to phytoestrogens in coffee that act differently in various tissues. Pancreatic cancer shows no significant link either way, while rarer cancers remain inconclusive due to limited data.
Coffee’s bioactive components
Coffee is much more than caffeine. It contains hundreds of biologically active compounds, including polyphenols, diterpenes, and melanoidins formed during roasting. Many of these have antioxidant and anti-inflammatory properties.
Interestingly, some protective effects are also seen with decaffeinated coffee, suggesting caffeine is not the sole factor. However, caffeinated coffee often shows stronger benefits, pointing to caffeine as a contributor alongside other compounds.
Coffee is even reported to be the number one source of antioxidants in the American diet. While this reflects poorly on the lack of fruit and vegetable intake, it also highlights how significant coffee can be as a dietary factor in health.
The reversal of bladder and lung cancer concerns
The original concern in 1991 centred on bladder cancer. With the benefit of over 10 prospective studies, this link has been largely dismissed. No significant association between coffee and bladder cancer has been confirmed, and IARC officially reversed its earlier classification in 2016.
Lung cancer presented a similar story. Early studies suggested higher risk, but when researchers adjusted for confounding factors such as smoking, often associated with heavy coffee drinking, the link disappeared. It was the cigarettes, not the coffee, that increased lung cancer risk.
The role of very hot coffee
There remains one exception: very hot coffee, consumed at temperatures above 65°C. Drinking extremely hot beverages of any kind, including tea or mate, can damage the cells of the oesophagus and mouth, increasing cancer risk in those tissues. This is not due to the coffee itself but to thermal injury. Allowing coffee to cool slightly before drinking eliminates this risk while also sparing the tongue.
Acrylamide concerns
Another debated issue is acrylamide, a chemical formed during the roasting process. While acrylamide is considered a probable carcinogen at high levels, the amount found in coffee is far below levels of concern. Regulatory bodies and scientists agree that acrylamide in coffee does not present a significant cancer risk.
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When coffee should be avoided
Despite its protective effects, coffee is not universally safe. Some individuals are hypersensitive to caffeine and may experience insomnia, palpitations or anxiety. Pregnant women are advised to limit or avoid coffee, as high caffeine intake has been linked to low birth weight and pre-term birth.
For the general adult population, however, moderate to high coffee consumption appears not only safe but beneficial in reducing the risk of several cancers.
From villain to protector
The story of coffee and cancer reflects how science evolves. In 1991, with limited and flawed evidence, coffee was placed in a suspect category. Over three decades of research, with stronger prospective studies, have revealed the opposite. Coffee is now associated with reduced risks of liver, endometrial, prostate and skin cancers, and potentially others.
This shift is unlikely to reverse again. The accumulation of data has increased confidence in coffee’s health benefits. Rather than being seen as a possible carcinogen, coffee is now recognised as one of the most widely consumed beverages with significant protective effects against cancer.
A new perspective on coffee and health
The morning cup that was once feared may, in fact, be a source of protection. While coffee is not a cure or guarantee against cancer, the weight of evidence shows that regular consumption supports better health outcomes, particularly for the liver and reproductive system.
Science has taken coffee from the dock as a possible carcinogen to the pedestal as a dietary ally. For millions of people who start their day with a warm cup, this is more than comforting news, it is evidence that their daily habit may contribute to a longer, healthier life.
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