Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study

Farhad Islami, Akram Pourshams, Dariush Nasrollahzadeh, Farin Kamangar, Saman Fahimi, Ramin Shakeri, Behnoush Abedi-Ardekani, Shahin Merat, Homayoon Vahedi, Shahryar Semnani, Christian C Abnet, Paul Brennan, Henrik Møller, Farrokh Saidi, Sanford M Dawsey, Reza Malekzadeh, Paolo Boffetta, Farhad Islami, Akram Pourshams, Dariush Nasrollahzadeh, Farin Kamangar, Saman Fahimi, Ramin Shakeri, Behnoush Abedi-Ardekani, Shahin Merat, Homayoon Vahedi, Shahryar Semnani, Christian C Abnet, Paul Brennan, Henrik Møller, Farrokh Saidi, Sanford M Dawsey, Reza Malekzadeh, Paolo Boffetta

Abstract

Objective: To investigate the association between tea drinking habits in Golestan province, northern Iran, and risk of oesophageal squamous cell carcinoma.

Design: Population based case-control study. In addition, patterns of tea drinking and temperature at which tea was drunk were measured among healthy participants in a cohort study.

Setting: Golestan province, northern Iran, an area with a high incidence of oesophageal squamous cell carcinoma.

Participants: 300 histologically proved cases of oesophageal squamous cell carcinoma and 571 matched neighbourhood controls in the case-control study and 48 582 participants in the cohort study.

Main outcome measure: Odds ratio of oesophageal squamous cell carcinoma associated with drinking hot tea.

Results: Nearly all (98%) of the cohort participants drank black tea regularly, with a mean volume consumed of over one litre a day. 39.0% of participants drank their tea at temperatures less than 60 degrees C, 38.9% at 60-64 degrees C, and 22.0% at 65 degrees C or higher. A moderate agreement was found between reported tea drinking temperature and actual temperature measurements (weighted kappa 0.49). The results of the case-control study showed that compared with drinking lukewarm or warm tea, drinking hot tea (odds ratio 2.07, 95% confidence interval 1.28 to 3.35) or very hot tea (8.16, 3.93 to 16.9) was associated with an increased risk of oesophageal cancer. Likewise, compared with drinking tea four or more minutes after being poured, drinking tea 2-3 minutes after pouring (2.49, 1.62 to 3.83) or less than two minutes after pouring (5.41, 2.63 to 11.1) was associated with a significantly increased risk. A strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk (weighted kappa 0.68).

Conclusion: Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer.

Conflict of interest statement

Competing interests: None declared.

References

    1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
    1. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24:2137-50.
    1. Blot WJ, McLaughlin JK, Fraumeni JF. Esophageal cancer. In: Schottenfeld D, Fraumeni JF, eds. Cancer epidemiology and prevention. New York: Oxford University Press, 2006.
    1. Mahboubi E, Kmet J, Cook PJ, Day NE, Ghadirian P, Salmasizadeh S. Oesophageal cancer studies in the Caspian Littoral of Iran: the Caspian cancer registry. Br J Cancer 1973;28:197-214.
    1. Cook-Mozaffari PJ, Azordegan F, Day NE, Ressicaud A, Sabai C, Aramesh B. Oesophageal cancer studies in the Caspian Littoral of Iran: results of a case-control study. Br J Cancer 1979;39:293-309.
    1. Nasrollahzadeh D, Kamangar F, Aghcheli K, Sotoudeh M, Islami F, Abnet CC, et al. Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran. Br J Cancer 2008;98:1857-63.
    1. Islami F, Kamangar F, Aghcheli K, Fahimi S, Semnani S, Taghavi N, et al. Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran. Br J Cancer 2004;90:1402-6.
    1. Tran GD, Sun XD, Abnet CC, Fan JH, Dawsey SM, Dong ZW, et al. Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China. Int J Cancer 2005;113:456-63.
    1. Kamangar F, Malekzadeh R, Dawsey SM, Saidi F. Esophageal cancer in northeastern Iran: a review. Arch Iran Med 2007;10:70-82.
    1. De Jong UW, Breslow N, Hong JG, Sridharan M, Shanmugaratnam K. Aetiological factors in oesophageal cancer in Singapore Chinese. Int J Cancer 1974;13:291-303.
    1. Launoy G, Milan C, Day NE, Faivre J, Pienkowski P, Gignoux M. Oesophageal cancer in France: potential importance of hot alcoholic drinks. Int J Cancer 1997;71:917-23.
    1. Castellsague X, Munoz N, De Stefani E, Victora CG, Castelletto R, Rolon PA. Influence of mate drinking, hot beverages and diet on esophageal cancer risk in South America. Int J Cancer 2000;88:658-64.
    1. Sharp L, Chilvers CE, Cheng KK, McKinney PA, Logan RF, Cook-Mozaffari P, et al. Risk factors for squamous cell carcinoma of the oesophagus in women: a case-control study. Br J Cancer 2001;85:1667-70.
    1. Phukan RK, Chetia CK, Ali MS, Mahanta J. Role of dietary habits in the development of esophageal cancer in Assam, the north-eastern region of India. Nutr Cancer 2001;39:204-9.
    1. Joint Iran-IARC group. Esophageal cancer studies in the Caspian littoral of Iran: results of population studies—a prodrome. Joint Iran-International Agency for Research on Cancer Study Group. J Natl Cancer Inst 1977;59:1127-38.
    1. Ghadirian P. Thermal irritation and esophageal cancer in northern Iran. Cancer 1987;60:1909-14.
    1. Abnet CC, Kamangar F, Islami F, Nasrollahzadeh D, Brennan P, Aghcheli K, et al. Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev 2008;17:3062-8.
    1. Malekshah AF, Kimiagar M, Saadatian-Elahi M, Pourshams A, Nouraie M, Goglani G, et al. Validity and reliability of a new food frequency questionnaire compared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer. Eur J Clin Nutr 2006;60:971-7.
    1. Pourshams A, Saadatian-Elahi M, Nouraie M, Malekshah AF, Rakhshani N, Salahi R, et al. Golestan cohort study of oesophageal cancer: feasibility and first results. Br J Cancer 2005;92:176-81.
    1. Yioris N, Ivankovic S, Lehnert T. Effect of thermal injury and oral administration of N-methyl-N’-Nitro-N-nitrosoguanidine on the development of esophageal tumors in Wistar rats. Oncology 1984;41:36-8.
    1. Li ZG, Shimada Y, Sato F, Maeda M, Itami A, Kaganoi J, et al. Promotion effects of hot water on N-nitrosomethylbenzylamine-induced esophageal tumorigenesis in F344 rats. Oncol Rep 2003;10:421-6.
    1. Dsvis RE, Ivy AC. Thermal irritation in gastric disease. Cancer 1949;2:138-43.
    1. De Jong UW, Day NE, Mounier-Kuhn PL, Haguenauer JP. The relationship between the ingestion of hot coffee and intraoesophageal temperature. Gut 1972;13:24-30.
    1. Mirvish SS. Role of N-nitroso compounds (NOC) and N-nitrosation in etiology of gastric, esophageal, nasopharyngeal and bladder cancer and contribution to cancer of known exposures to NOC. Cancer Lett 1995;93:17-48.
    1. Putz A, Hartmann AA, Fontes PR, Alexandre CO, Silveira DA, Klug SJ, et al. TP53 mutation pattern of esophageal squamous cell carcinomas in a high risk area (southern Brazil): role of life style factors. Int J Cancer 2002;98:99-105.
    1. Breton J, Sichel F, Abbas A, Marnay J, Arsene D, Lechevrel M. Simultaneous use of DGGE and DHPLC to screen TP53 mutations in cancers of the esophagus and cardia from a European high incidence area (lower Normandy, France). Mutagenesis 2003;18:299-306.
    1. Biramijamal F, Allameh A, Mirbod P, Groene HJ, Koomagi R, Hollstein M. Unusual profile and high prevalence of p53 mutations in esophageal squamous cell carcinomas from northern Iran. Cancer Res 2001;61:3119-23.
    1. Sepehr A, Taniere P, Martel-Planche G, Zia’ee AA, Rastgar-Jazii F, Yazdanbod M, et al. Distinct pattern of TP53 mutations in squamous cell carcinoma of the esophagus in Iran. Oncogene 2001;20:7368-74.
    1. Ambs S, Bennett WP, Merriam WG, Ogunfusika MO, Oser SM, Harrington AM, et al. Relationship between p53 mutations and inducible nitric oxide synthase expression in human colorectal cancer. J Natl Cancer Inst 1999;91:86-8.
    1. Tobey NA, Sikka D, Marten E, Caymaz-Bor C, Hosseini SS, Orlando RC. Effect of heat stress on rabbit esophageal epithelium. Am J Physiol 1999;276:G1322-30.
    1. Kamangar F, Strickland PT, Pourshams A, Malekzadeh R, Boffetta P, Roth MJ, et al. High exposure to polycyclic aromatic hydrocarbons may contribute to high risk of esophageal cancer in northeastern Iran. Anticancer Res 2005;25:425-8.
    1. Hakami R, Mohtadinia J, Etemadi A, Kamangar F, Nemati M, Pourshams A, et al. Dietary intake of benzo(a)pyrene and risk of esophageal cancer in North of Iran. Nutr Cancer 2008;60:216-21.
    1. Ames BN, Wakimoto P. Are vitamin and mineral deficiencies a major cancer risk? Nat Rev Cancer 2002;2:694-704.
    1. Wang ZY, Wang LD, Lee MJ, Ho CT, Huang MT, Conney AH, et al. Inhibition of N-nitrosomethylbenzylamine-induced esophageal tumorigenesis in rats by green and black tea. Carcinogenesis 1995;16:2143-8.
    1. Boone CW, Stoner GD, Bacus JV, Kagan V, Morse MA, Kelloff GJ, et al. Chemoprevention with theaflavins of rat esophageal intraepithelial neoplasia quantitatively monitored by image tile analysis. Cancer Epidemiol Biomarkers Prev 2000;9:1149-54.
    1. De Boer JG, Yang H, Holcroft J, Skov K. Chemoprotection against N-nitrosomethylbenzylamine-induced mutation in the rat esophagus. Nutr Cancer 2004;50:168-73.
    1. Yang CS, Lambert JD, Ju J, Lu G, Sang S. Tea and cancer prevention: molecular mechanisms and human relevance. Toxicol Appl Pharmacol 2007;224:265-73.
    1. Shukla Y. Tea and cancer chemoprevention: a comprehensive review. Asian Pac J Cancer Prev 2007;8:155-66.
    1. Sewram V, De Stefani E, Brennan P, Boffetta P. Mate consumption and the risk of squamous cell esophageal cancer in Uruguay. Cancer Epidemiol Biomarkers Prev 2003;12:508-13.
    1. Fagundes RB, Abnet CC, Strickland PT, Kamangar F, Roth MJ, Taylor PR, et al. Higher urine 1-hydroxy pyrene glucuronide (1-OHPG) is associated with tobacco smoke exposure and drinking mate in healthy subjects from Rio Grande do Sul, Brazil. BMC Cancer 2006;6:139.
    1. Kamangar F, Schantz MM, Abnet CC, Fagundes RB, Dawsey SM. High levels of carcinogenic polycyclic aromatic hydrocarbons in mate drinks. Cancer Epidemiol Biomarkers Prev 2008;17:1262-8.
    1. Edwards FC, Edwards JH. Tea drinking and gastritis. Lancet 1956;271:543-5.
    1. Pearson RC, McCloy RF. Preference for hot drinks is associated with peptic disease. Gut 1989;30:1201-5.
    1. Victora CG, Munoz N, Horta BL, Ramos EO. Patterns of mate drinking in a Brazilian city. Cancer Res 1990;50:7112-5.
    1. Graham DY, Abou-Sleiman J, El Zimaity HM, Badr A, Graham DP, Malaty HM. Helicobacter pylori infection, gastritis, and the temperature of choice for hot drinks. Helicobacter 1996;1:172-4.
    1. McLaughlin JK, Gridley G, Block G, Winn DM, Preston-Martin S, Schoenberg JB, et al. Dietary factors in oral and pharyngeal cancer. J Natl Cancer Inst 1988;80:1237-43.
    1. Gangane N, Chawla S, Anshu, Gupta SS, Sharma SM. Reassessment of risk factors for oral cancer. Asian Pac J Cancer Prev 2007;8:243-8.
    1. World Cancer Research Fund and American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC: AICR, 2007.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する