We have known for a long time that estrogen can protect against colon cancer and that women who take hormone replacement can also prevent polyps and cancer development. We also have recently seen that women do better than men when younger than 45 years old.

How estrogen can protect is still unclear, However we know that estrogen receptors are expressed in the colon which may be responsible for the estrogen effect. This compound identified in coffee has shown to be estrogenic. These studies are done by Texas AgriLife Research scientists.

We don’t have any data on how much coffee we need to drink to have this effect, but the scientists say the compound, called trigonelline or “trig,” may be a factor in estrogen-dependent breast cancer but beneficial against colon cancer development. These data were published in the Journal of Nutrition.

Dr. Clinton Allred’s lab studies dietary compounds that can mimic the hormone estradiol – the primary hormone in women. His main focus has been to look at how estrogen protects against the development of colon cancer. Estradiol is one of three estrogen hormones.

We have seen data in recent years that modulation of estrogen with soy, which is able to decrease estrogen levels, has an effect on breast cancer and colon cancer, but in opposite ways. Soy can increase breast cancer risk but not the risk of colon cancer, because estrogen can protect against colon cancer.

The data from Dr. Allred show that “trig” is in coffee beans, though in different amounts depending on the variety of coffee bean.

Dr. Allred said,

The more you roast a coffee bean, the less there is. But the most critical aspect is that when you do a water extract of ground coffee, which is basically how you make a cup of coffee. It does in fact come out in the water, so we know it is in a cup of coffee.

We need much more data to better understand what this substance is able to do and what the mechanisms of actions are before we run to Starbucks and order a double latte.

However, women over 50 had about 40 percent poorer survival than men over 50.  Again, stage, site, or grade at the time of diagnosis didn’t matter.

The South Western Sydney Colorectal Tumour Group registry studied data for men and women diagnosed with colorectal cancer between 1997 and 2004.  Compared to men, women

• were older at diagnosis (median age 69 versus 67 for men)
• were more likely to have tumors on the right side of their colons (42.2% of women vs. 31.5% of men)
• needed emergency surgery more often (18.8% vs. 15.1%)
• had more poorly differentiated tumors (16.9% vs. 12.9%)

Women were less likely to receive radiotherapy treatment for rectal cancer.  A little over a third of women with rectal cancer (36.4 percent) had radiation treatment compared to almost half of men (48.1 percent).   However, there were no differences in treatment with chemotherapy.

There were also no differences in stage at diagnosis or tumor pathology.

The study did not include information about use of estrogen therapy or actual data on whether women had experienced menopause.

Dr. Jenn H. Koo and her colleagues in Sydney concluded,

This study demonstrated an opposing effect of gender on overall and cancer-specific survival at either side of the age of 50 years. The protective effect of estrogen on CRC may be an important factor. Women had a greater proportion of emergency surgery, which was related to the predominance of proximal cancers in this gender. Women also had more proximal cancers, thereby limiting flexible sigmoidoscopy as a screening test.

Another article about the study is available from Reuters Health.

SOURCE: Koo et al., American Journal of Gastroenterology, Volume 103,  Issue 6, June 2008.