Tea consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling (StoP) Project consortium

Georgia Martimianaki^{1

2}, Gianfranco Alicandro^{3

4}, Claudio Pelucchi⁵, Rossella Bonzi⁵, Matteo Rota⁶, Jinfu Hu⁷, Kenneth C Johnson⁸, Charles S Rabkin⁹, Linda M Liao⁹, Rashmi Sinha⁹, Zuo-Feng Zhang¹⁰, Michela Dalmartello⁵, Nuno Lunet^{11

12

13}, Samantha Morais^{11

12

13}, Domenico Palli¹⁴, Monica Ferraroni⁵, Guo-Pei Yu¹⁵, Shoichiro Tsugane^{16

17}, Akihisa Hidaka¹⁶, Maria Paula Curado¹⁸, Emmanuel Dias-Neto¹⁸, David Zaridze¹⁹, Dmitry Maximovitch¹⁹, Jesus Vioque^{20

21}, Manoli Garcia de la Hera^{20

21}, Lizbeth López-Carrillo²², Raúl Ulises Hernández-Ramírez²³, Gerson Shigueaki Hamada²⁴, Mary H Ward⁹, Lina Mu²⁵, Reza Malekzadeh²⁶, Farhad Pourfarzi²⁷, Antonia Trichopoulou²⁸, Anna Karakatsani^{28

29}, Robert C Kurtz³⁰, Areti Lagiou³¹, Pagona Lagiou^{32

33}, Stefania Boccia^{34

35}, Paolo Boffetta^{36

37}, M Constanza Camargo⁹, Eva Negri^{5

37

38}, Carlo La Vecchia⁵

Affiliations

¹ Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy. georgia.martimianaki@unimi.it.
² Hellenic Health Foundation, Athens, Greece. georgia.martimianaki@unimi.it.
³ Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
⁴ Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁵ Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy.
⁶ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
⁷ Harbin Medical University, Harbin, China.
⁸ School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
¹⁰ Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
¹¹ EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
¹² Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
¹³ Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
¹⁴ Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
¹⁵ Medical Informatics Center, Peking University, Peking, China.
¹⁶ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
¹⁷ National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
¹⁸ Centro Internacional de Pesquisas, A.C. Camargo Cancer Center, São Paulo, Brazil.
¹⁹ Department of clinical epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia.
²⁰ Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
²¹ Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain.
²² Mexico National Institute of Public Health, Morelos, Mexico.
²³ Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA.
²⁴ Nikkei Disease Prevention Center, São Paulo, Brazil.
²⁵ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.
²⁶ Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁷ Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
²⁸ Hellenic Health Foundation, Athens, Greece.
²⁹ 2nd Pulmonary Medicine Department, National and Kapodistrian University of Athens, Medical School, "ATTIKON" University Hospital, Haidari, Greece.
³⁰ Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA.
³¹ Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece.
³² Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
³³ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³⁴ Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia.
³⁵ Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
³⁶ Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
³⁷ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁸ Pegaso Online University, Naples, Italy.

PMID: 35610368
PMCID: PMC9381730
DOI: 10.1038/s41416-022-01856-w

Tea consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling (StoP) Project consortium

Georgia Martimianaki et al. Br J Cancer. 2022 Sep.

. 2022 Sep;127(4):726-734.

doi: 10.1038/s41416-022-01856-w. Epub 2022 May 24.

Authors

Affiliations

¹ Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy. georgia.martimianaki@unimi.it.
² Hellenic Health Foundation, Athens, Greece. georgia.martimianaki@unimi.it.
³ Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
⁴ Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁵ Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy.
⁶ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
⁷ Harbin Medical University, Harbin, China.
⁸ School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
¹⁰ Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
¹¹ EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
¹² Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
¹³ Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
¹⁴ Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
¹⁵ Medical Informatics Center, Peking University, Peking, China.
¹⁶ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
¹⁷ National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
¹⁸ Centro Internacional de Pesquisas, A.C. Camargo Cancer Center, São Paulo, Brazil.
¹⁹ Department of clinical epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia.
²⁰ Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
²¹ Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain.
²² Mexico National Institute of Public Health, Morelos, Mexico.
²³ Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA.
²⁴ Nikkei Disease Prevention Center, São Paulo, Brazil.
²⁵ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.
²⁶ Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
²⁷ Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
²⁸ Hellenic Health Foundation, Athens, Greece.
²⁹ 2nd Pulmonary Medicine Department, National and Kapodistrian University of Athens, Medical School, "ATTIKON" University Hospital, Haidari, Greece.
³⁰ Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA.
³¹ Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece.
³² Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
³³ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³⁴ Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia.
³⁵ Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
³⁶ Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
³⁷ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁸ Pegaso Online University, Naples, Italy.

PMID: 35610368
PMCID: PMC9381730
DOI: 10.1038/s41416-022-01856-w

Abstract

Background: Evidence from epidemiological studies on the role of tea drinking in gastric cancer risk remains inconsistent. We aimed to investigate and quantify the relationship between tea consumption and gastric cancer in the Stomach cancer Pooling (StoP) Project consortium.

Methods: A total of 9438 cases and 20,451 controls from 22 studies worldwide were included. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of gastric cancer for regular versus non-regular tea drinkers were estimated by one and two-stage modelling analyses, including terms for sex, age and the main recognised risk factors for gastric cancer.

Results: Compared to non-regular drinkers, the estimated adjusted pooled OR for regular tea drinkers was 0.91 (95% CI: 0.85-0.97). When the amount of tea consumed was considered, the OR for consumption of 1-2 cups/day was 1.01 (95% CI: 0.94-1.09) and for >3 cups/day was 0.91 (95% CI: 0.80-1.03). Stronger inverse associations emerged among regular drinkers in China and Japan (OR: 0.67, 95% CI: 0.49-0.91) where green tea is consumed, in subjects with H. pylori infection (OR: 0.68, 95% CI: 0.58-0.80), and for gastric cardia cancer (OR: 0.64, 95% CI: 0.49-0.84).

Conclusion: Our results indicate a weak inverse association between tea consumption and gastric cancer.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1. Overall regular tea consumption and gastric cancer.**
Study-specific, adjusted pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of gastric cancer for regular tea drinkers compared with non-regular tea drinkers in the Stomach cancer Pooling (StoP) Project consortium.

**Fig. 2. Categories of tea consumption and gastric cancer.**
Study-specific, adjusted pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of gastric cancer for tea drinkers of 1–2 cups per day (a) and ≥3 cups per day (b) compared with non-regular tea drinkers in the Stomach cancer Pooling (StoP) Project consortium. Studies with more than five subjects in exposed cases or controls are shown in figures (a) and (b).

**Fig. 3. Overall tea consumption and gastric cancer in strata of selected variables.**
Adjusted pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for regular tea consumption compared to non-regular tea consumption, according to strata of selected variables in the Stomach cancer Pooling (StoP) Project consortium.

**Fig. 4. Tea-drinking intensity (as a continuous variable) and gastric cancer.**
Dose-response relationship between tea consumption and gastric cancer (adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs)) fitted by natural cubic splines in a one-stage linear random-effects model in the Stomach cancer Pooling (StoP) Project consortium.

See this image and copyright information in PMC

References

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Tea consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling (StoP) Project consortium

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Tea consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling (StoP) Project consortium

Authors

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Abstract

Conflict of interest statement

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