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Green tea consumption and gastric cancer in Japanese: a pooled analysis of six cohort studies
  1. M Inoue1,
  2. S Sasazuki1,
  3. K Wakai2,
  4. T Suzuki3,
  5. K Matsuo3,
  6. T Shimazu1,4,
  7. I Tsuji4,
  8. K Tanaka5,
  9. T Mizoue6,
  10. C Nagata7,
  11. A Tamakoshi8,
  12. N Sawada1,
  13. S Tsugane1,
  14. for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan
  1. 1
    Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
  2. 2
    Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan
  3. 3
    Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
  4. 4
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
  5. 5
    Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
  6. 6
    Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan
  7. 7
    Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
  8. 8
    Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan
  1. 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}


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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  • Funding This study was supported by a Grant for the Third Term Comprehensive Control Research for Cancer from the Ministry of Health, Labour and Welfare of Japan. Financial disclosure: none.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval Approval for this study was given by the National Cancer Center, Tokyo, on 17 September 2008; by the Tohoku University Graduate School of Medicine on 24 July 2000 and 23 October 2000; by the Aichi Medical University on 7 July 2008; and by the Aichi Cancer Center, Nagoya, on 31 March 1986.

  • Members of the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan

  • S Tsugane (principal investigator), M Inoue, S Sasazuki, M Iwasaki, T Otani (until 2006), N Sawada (since 2007), T Shimazu (since 2007) (National Cancer Center, Tokyo); I Tsuji (since 2004), Y Tsubono (in 2003) (Tohoku University, Sendai); Y Nishino (until 2006) (Miyagi Cancer Research Institute, Natori, Miyagi); K Wakai (Nagoya University, Nagoya); K Matsuo (since 2006) (Aichi Cancer Center, Nagoya); C Nagata (Gifu University, Gifu); T Mizoue (International Medical Center of Japan, Tokyo); K Tanaka (Saga University, Saga).

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