title: Green tea (Camellia sinensis) for the prevention of cancer.
abstract: BACKGROUND
  Tea is one of the most commonly consumed beverages worldwide. Teas from the plant Camellia sinensis can be grouped into green, black and oolong tea. Cross-culturally tea drinking habits vary. Camellia sinensis contains the active ingredient polyphenol, which has a subgroup known as catechins. Catechins are powerful antioxidants. It has been suggested that green tea polyphenol may inhibit cell proliferation and observational studies have suggested that green tea may have cancer-preventative effects.
  
  
  OBJECTIVE
  To critically assess any associations between green tea consumption and the risk of cancer incidence and mortality.
  
  
  METHODS
  We searched eligible studies up to January 2009 in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Amed, CancerLit, Psych INFO and Phytobase and reference lists of previous reviews and included studies.
  
  
  METHODS
  We included all prospective, controlled interventional studies and observational studies, which either assessed the associations between green tea consumption and risk of cancer incidence or that reported on cancer mortality.
  
  
  METHODS
  At least two review authors independently applied the study criteria, extracted data and assessed methodological quality of studies. Due to the nature of included studies, which were mainly epidemiological, results were summarised descriptively according to cancer diagnosis.
  
  
  RESULTS
  Fifty-one studies with more than 1.6 million participants were included. Twenty-seven of them were case-control studies, 23 cohort studies and one randomised controlled trial (RCT).Twenty-seven studies tried to establish an association between green tea consumption and cancer of the digestive tract, mainly of the upper gastrointestinal tract, five with breast cancer, five with prostate cancer, three with lung cancer, two with ovarian cancer, two with urinary bladder cancer one with oral cancer, three further studies included patients with various cancer diagnoses.The methodological quality was measured with the Newcastle-Ottawa scale (NOS). The 9 nested case-control studies within prospective cohorts were of high methodological quality, 13 of medium, and 1 of low. One retrospective case-control study was of high methodological quality and 21 of medium and 5 of low.Results from studies assessing associations between green tea and risk of digestive tract cancer incidence were highly contradictory. There was limited evidence that green tea could reduce the incidence of liver cancer. The evidence for esophageal, gastric, colon, rectum, and pancreatic cancer was conflicting. In prostate cancer, observational studies with higher methodological quality and the only included RCT suggested a decreased risk in men consuming higher quantities green tea or green tea extracts. However, there was limited to moderate evidence that the consumption of green tea reduced the risk of lung cancer, especially in men, and urinary bladder cancer or that it could even increase the risk of the latter. There was moderate to strong evidence that green tea consumption does not decrease the risk of dying from gastric cancer. There was limited moderate to strong evidence for lung, pancreatic and colorectal cancer.
  
  
  CONCLUSIONS
  There is insufficient and conflicting evidence to give any firm recommendations regarding green tea consumption for cancer prevention. The results of this review, including its trends of associations, need to be interpreted with caution and their generalisability is questionable, as the majority of included studies were carried out in Asia (n = 47) where the tea drinking culture is pronounced. Desirable green tea intake is 3 to 5 cups per day (up to 1200 ml/day), providing a minimum of 250 mg/day catechins. If not exceeding the daily recommended allowance, those who enjoy a cup of green tea should continue its consumption. Drinking green tea appears to be safe at moderate, regular and habitual use.
authors: Medizinische Klinik 5-Schwerpunkt Onkologie / Haematologie, Klinikum Nord, Prof.-Ernst-Nathan-Str. 1, Nuernberg, Germany, D-90419.
authors: Katja
authors: K
authors: Boehm
authors: Francesca
authors: F
authors: Borrelli
authors: Edzard
authors: E
authors: Ernst
authors: Gabi
authors: G
authors: Habacher
authors: Shao Kang
authors: SK
authors: Hung
authors: Stefania
authors: S
authors: Milazzo
authors: Markus
authors: M
authors: Horneber
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control; D028241:Camellia sinensis / Q000737:chemistry; D005260:Female; D005419:Flavonoids / Q000494:pharmacology; D005770:Gastrointestinal Neoplasms / Q000517:prevention & control; D006801:Humans; D008113:Liver Neoplasms / Q000517:prevention & control; D008175:Lung Neoplasms / Q000517:prevention & control; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D010636:Phenols / Q000494:pharmacology; D059808:Polyphenols; D011471:Prostatic Neoplasms / Q000517:prevention & control; D013662:Tea / Q000009:adverse effects; D014565:Urogenital Neoplasms / Q000517:prevention & control
chemical_list: D005419:Flavonoids; D010636:Phenols; D059808:Polyphenols; D013662:Tea