Gastric cancer

Green tea consumption and gastric cancer in Japanese: a pooled analysis of six cohort studies

M Inoue¹, S Sasazuki¹, K Wakai², T Suzuki³, K Matsuo³, T Shimazu^1,4, I Tsuji⁴, K Tanaka⁵, T Mizoue⁶, C Nagata⁷, A Tamakoshi⁸, N Sawada¹, S Tsugane¹, for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan

¹ Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
² Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan
³ Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
⁴ Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
⁵ Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
⁶ Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan
⁷ Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
⁸ Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan

^{Correspondence to} Dr M Inoue, Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan; mnminoue{at}ncc.go.jp

Background: Previous experimental studies have suggested many possible anti-cancer mechanisms for green tea, but epidemiological evidence for the effect of green tea consumption on gastric cancer risk is conflicting.

Objective: To examine the association between green tea consumption and gastric cancer.

Methods: We analysed original data from six cohort studies that measured green tea consumption using validated questionnaires at baseline. Hazard ratios (HRs) in the individual studies were calculated, with adjustment for a common set of variables, and combined using a random-effects model.

Results: During 2 285 968 person-years of follow-up for a total of 219 080 subjects, 3577 cases of gastric cancer were identified. Compared with those drinking <1 cup/day, no significant risk reduction for gastric cancer was observed with increased green tea consumption in men, even in stratified analyses by smoking status and subsite. In women, however, a significantly decreased risk was observed for those with consumption of 5 cups/day (multivariate-adjusted pooled HR = 0.79, 95% confidence interval (CI) = 0.65 to 0.96). This decrease was also significant for the distal subsite (HR = 0.70, 95% CI = 0.50 to 0.96). In contrast, a lack of association for proximal gastric cancer was consistently seen in both men and women.

Conclusions: Green tea may decrease the risk of distal gastric cancer in women.

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