We examined the risk of lung cancer in relation to green tea consumption in a population-based cohort study in Japan among 41 440 men and women, aged 40 -79 years, who completed a questionnaire in 1994 regarding green tea consumption and other healthrelated lifestyle factors. During the follow-up period of 7 years (from 1995 to 2001), 302 cases of lung cancer were identified, and the Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The multivariable-adjusted HRs of lung cancer incidence for green tea consumption of 1 or 2, 3 or 4, and 5 or more cups/day as compared to less than 1 cup/day were 1.14 (95% CI: 0.80 -1.62), 1.18 (95% CI: 0.83 -1.66), and 1.17 (95% CI: 0.85 -1.61), respectively (P for trend ¼ 0.48). This cohort study has found no evidence that green tea consumption is associated with lung cancer. , 1952 -2005).Evidence from in vitro and animal experiments has suggested that green tea polyphenols protect against lung cancer through their antimutagenic and antioxidant properties (Valcic et al, 1996;Okabe et al, 1997;Yang et al, 1998Yang et al, , 2005Fujimoto et al, 2002;Chen et al, 2004;Kuzuhara et al, 2007; Sadava et al, 2007). To the best of our knowledge, only two studies (of atomic bomb survivors and postmenopausal women) have investigated lung cancer risk in relation to green tea or total tea consumption (Zheng et al, 1996;Nagano et al, 2001), and both found no association.In a population-based prospective study of men and women in Miyagi Prefecture in northeastern Japan, where about 75% of the population drinks green tea everyday (Suzuki et al, 2004), we investigated further whether an association exists between green tea consumption and lung cancer risk.
MATERIALS AND METHODSThe details of this Ohsaki National Health Insurance (NHI) cohort study have been published elsewhere (Tsuji et al, 1998;Kikuchi et al, 2006;Kuriyama et al, 2006;Nakaya et al, 2007). In brief, a baseline self-administered questionnaire was distributed to all NHI beneficiaries aged 40 -79 years living in the catchment area of the Ohsaki Public Health Center, Miyagi Prefecture, in northeastern Japan from October to December 1994. From 54 996 eligible individuals, 52 029 (94.6%) individuals responded to the survey. We considered the return of self-administered questionnaires signed by the participants to imply their consent to participate in the study. The study protocol was approved by the institutional review board of the Tohoku University Graduate School of Medicine.We excluded 776 individuals who had withdrawn from the NHI before we started the prospective study, 3038 individuals with a prior history of cancer, 6355 individuals with missing data on green tea consumption, and 420 individuals who had reported extreme daily energy intake (outside of the sex-specific cutoff points of lower 0.5% and upper 0.5%). Finally, 41 440 individuals were involved in the final analysis.The baseline survey questionnaire contained items on basic personal health informa...