Abstract
Keywords
To the Editor,
Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and cutaneous malignant melanoma (CMM) represent the most common cutaneous malignancies worldwide and continue to pose a substantial public health burden. Although ultraviolet radiation (UVR) exposure remains a significant risk factor for skin cancers, lifestyle factors including dietary intake may modulate skin cancer risk through bioactive compounds.1-3 We performed a systematic review to evaluate the association between non-alcoholic beverage consumption and cutaneous malignancy risk.
Medline, EMBASE, and Web of Science were searched following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (Supplementary Table 1). Thirty-one studies were included in the final analysis and the sample sizes for the included studies ranged from 324 to 447 357. Detailed data extraction can be found in Supplementary Tables 2 to 4.
Caffeinated coffee demonstrated the most consistent protective association. Ten studies reported that higher intake was associated with a reduced BCC risk and to a lesser extent, CMM. Seven studies reported dose-response relationships with ≥4 cups/day conferring the greatest benefit. One study reported that a daily caffeine intake of ≥400 mg/day conferred the greatest protection against SCC and a daily caffeine intake of 250 to 400 mg provided the greatest protection against BCC. 4 In contrast, decaffeinated coffee (n = 4) and studies without specification of coffee type (n = 5) showed no significant associations.
Evidence for tea consumption (n = 19) was heterogenous. Four studies reported an inverse association with SCC and BCC, with black tea showing the most consistent effect, whereas 15 studies found no relationship or modestly elevated CMM risk. Additionally, individuals consuming ≥2 cups of tea daily or with long-term intake (≥47 years) exhibited reduced SCC risk. 5 Variability in tea type, preparation, and duration of consumption likely contributed to inconsistent findings. All tea studies included were non-herbal.
Citrus juice intake, particularly orange juice (n = 6) was strongly associated with an increased risk of BCC, SCC, and CMM. This association is attributable to furocoumarins, which are photoactive compounds capable of lowering the minimal erythema dose and inducing DNA damage when activated by UVR. Alternatively, grapefruit juice showed null associations, potentially reflecting differences in consumption patterns.
Evidence for other beverages was limited. Studies of soft drink consumption (n = 2) demonstrated no association with CMM risk, whereas milk intake (n = 2) was associated with an increased risk of CMM and BCC in some analyses. However, the small number of studies and methodological variability preclude definitive conclusions.
Several limitations warrant consideration. Most studies relied on single baseline dietary assessments, which may not reflect long-term intake. Beverage exposure was often broadly categorized with limited data on preparation methods and serving sizes. Most cohorts in this systematic review were predominantly Caucasian, limiting generalizability.
Overall, habitual beverage consumption may influence skin cancer risk. Caffeinated coffee appears protective, whereas citrus juice intake may increase risk. Evidence for tea and other beverages remains inconclusive. Future research should evaluate the effects of beverage intake on other photosensitive disorders such as lupus, dermatomyositis, and porphyria. An improved understanding of beverage-specific bioactive compounds may inform dietary guidance for individuals at elevated risk of skin cancer, including immunocompromised populations.
Supplemental Material
sj-docx-2-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-docx-2-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Supplemental Material
sj-docx-3-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-docx-3-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Supplemental Material
sj-docx-4-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-docx-4-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Supplemental Material
sj-docx-5-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-docx-5-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Supplemental Material
sj-docx-6-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-docx-6-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Supplemental Material
sj-png-1-cms-10.1177_12034754261460061 – Supplemental material for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review
Supplemental material, sj-png-1-cms-10.1177_12034754261460061 for Non-Alcoholic Beverage Intake and Risk of Cutaneous Malignancies: A Systematic Review by Kim H. Tran, Kimia Ameri, Quyen Pham, Mariusz Sapijaszko and Eunice Y. Chow in Journal of Cutaneous Medicine and Surgery
Footnotes
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Supplemental Material
Supplemental material for this article is available online.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
