The effect of green tea drinking in reducing human cancer risk is unclear, though a protective effect has been reported in numerous animal studies and several epidemiologic investigations. Herein the hypothesis that green tea consumption may reduce the risk of cancers of the colon, rectum and pancreas is examined in a large population-based case-control study conducted in Shanghai, China. Newly diagnosed cancer cases (931 colon, 884 rectum and 451 pancreas) during 1990-1993 among residents 30-74 years of age were included. Controls (n 5 1,552) were selected among Shanghai residents and frequency-matched to cases by gender and age. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) of each cancer associated with green tea consumption were derived after adjustment for age, income, education and cigarette smoking. Additional adjustment for dietary items and body size was found to have minimal impact. An inverse association with each cancer was observed with increasing amount of green tea consumption, with the strongest trends for rectal and pancreatic cancers. r 1997 Wiley-Liss, Inc.* Tea preparations and tea polyphenols have been shown to inhibit formation and growth of a variety of solid tumors in laboratory rats and mice (Katiyar et al., 1993;Yang and Wang, 1993;Han, 1993;Narisawa and Fukaura, 1993;Mukhtar et al., 1994;Yin et al., 1994;Wang et al., 1994;Hirose et al., 1994;Bu-Abbas et al., 1995). Evidence for a protective effect of tea drinking on human cancers, however, has been inconclusive (IARC, 1991), though a reduced risk of gastrointestinal cancers has been suggested among green tea drinkers in several epidemiologic studies (Kono et al., 1988;Kato et al., 1990;Gao et al., 1994;Yu et al., 1995;Ji et al., 1996). Since green tea is one of the most commonly consumed beverages among Chinese adults, the wide range of intake levels provides a special opportunity to assess the association between green tea drinking and cancer risks. Herein we examine the association between green tea drinking and the risk of cancers of the colon, rectum and pancreas.
MATERIAL AND METHODSThe methods for the study have been described in detail elsewhere (Ji et al., 1995). Briefly, cases were permanent Shanghai residents newly diagnosed with cancers of the colon, rectum or pancreas at ages 30-74 between October 1990 and June 1993, identified through the Shanghai Cancer Registry. A standardized medical abstract was used to collect information on date, method and outcome of diagnosis. Controls were selected randomly from files of permanent residents of Shanghai and frequency-matched to cases by age (5-year categories) and sex.Study subjects were interviewed in person by trained interviewers using a standardized questionnaire to elicit information on demographic and residential characteristics; dietary practices; consumption of cigarettes, alcohol and tea; height and weight; medical history; family cancer history; occupation; and physical activity. Information on tea consumption included regular tea drinking status (defi...