Yu C, Tang H, Guo Y, Bian Z, Yang L, Chen Y, Tang A, Zhou X, Yang X, Chen J, Chen Z, Lv J, Li L. Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study.
Ann Intern Med 2018;
168:489-497. [PMID:
29404576 PMCID:
PMC6675598 DOI:
10.7326/m17-2000]
[Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED
This article has been corrected. The original version (PDF) is appended to this article as a Supplement.
BACKGROUND
Although consumption of tea at high temperatures has been suggested as a risk factor for esophageal cancer, an association has not been observed consistently, and whether any relationship is independent of alcohol and tobacco exposure has not been evaluated.
OBJECTIVE
To examine whether high-temperature tea drinking, along with the established risk factors of alcohol consumption and smoking, is associated with esophageal cancer risk.
DESIGN
China Kadoorie Biobank, a prospective cohort study established during 2004 to 2008.
SETTING
10 areas across China.
PARTICIPANTS
456 155 persons aged 30 to 79 years. Those who had cancer at baseline or who reduced consumption of tea, alcohol, or tobacco before baseline were excluded.
MEASUREMENTS
The usual temperature at which tea was consumed, other tea consumption metrics, and lifestyle behaviors were self-reported once, at baseline. Outcome was esophageal cancer incidence up to 2015.
RESULTS
During a median follow-up of 9.2 years, 1731 incident esophageal cancer cases were documented. High-temperature tea drinking combined with either alcohol consumption or smoking was associated with a greater risk for esophageal cancer than hot tea drinking alone. Compared with participants who drank tea less than weekly and consumed fewer than 15 g of alcohol daily, those who drank burning-hot tea and 15 g or more of alcohol daily had the greatest risk for esophageal cancer (hazard ratio [HR], 5.00 [95% CI, 3.64 to 6.88]). Likewise, the HR for current smokers who drank burning-hot tea daily was 2.03 (CI, 1.55 to 2.67).
LIMITATION
Tea consumption was self-reported once, at baseline, leading to potential nondifferential misclassification and attenuation of the association.
CONCLUSION
Drinking tea at high temperatures is associated with an increased risk for esophageal cancer when combined with excessive alcohol or tobacco use.
PRIMARY FUNDING SOURCE
National Natural Science Foundation of China and National Key Research and Development Program.
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