Summary Following the report from Hawaii (Heilbrun et al., 1986) of relationships between tea consumption and respectively rectal cancer (positive) and prostate cancer (negative), these questions were examined using data from a prospective mortality study of London men initiated in 1967. The small numbers of men who did not usually drink any tea prevented a reliable study of this sub group. Nevertheless no evidence of a dose-response relationship was found for rectal, colon or prostate cancer. Significant relationships were found, however, between tea consumption and deaths from stomach, lung and kidney cancers. In the case of stomach and lung cancer, these were partly due to the effects of social class and smoking, and possible reasons are considered for the residual relations.A prospective study of men of Japanese ancestry in Hawaii reported that, compared with those who seldom or never drank black tea, habitual drinkers showed an increased incidence of rectal cancer, and that there was a doseresponse relationship (Heilbrun et al., 1986). ('Black tea' is the commonest type of tea and that which is mainly drunk in Britain). In addition, prostate cancer showed a weaker, negative association with tea consumption. This has prompted us to investigate the mortality from rectal and other cancers in relation to tea consumption, using data from a prospective study initiated by one of us (JY) in 1967.
MethodsA random sample of about 20,000 men aged 45-60 in London was sent questionnaires about diet (including consumption of tea, coffee and other beverages) and smoking habits, by the General Register Office in December 1967. Respondents were 'flagged' in the NHS Central Register so that deaths, and their causes, could be identified as they occurred. Details of causes of death were coded by the Office of Population Censuses and Surveys (OPCS). These details, together with those on diet, were provided by OPCS without disclosure of identities.The questionnaire asked for the average consumption of tea and other beverages before breakfast, at breakfast, midmorning break, midday, tea-time, evening, bed-time, or at any other time. Man-years at risk were calculated by tea consumption category from the end of June 1969 to the end of 1986, or to death or emigration if earlier. Expected numbers of deaths from different causes were calculated by multiplying the age-specific mortality rates for men in England and Wales in the different calendar periods by the corresponding man-years at risk.Statistical modelling of the data was carried out using the computer package GLIM (Baker & Nelder, 1978). For this purpose it was assumed that observed deaths are Poisson variables with means proportional to the corresponding expected numbers (Breslow et al., 1983).Of the approximately 20,000 questionnaires that were sent, replies were received from 14,453 men, and of these the 14,085 (97%) who were traced in the NHS Central Register form the study population.By the end of 1986, a total of 5,732 deaths had been recorded in the study population. An...