Intervention Review

Green tea (Camellia sinensis) for the prevention of cancer

  1. Katja Boehm1,*,
  2. Francesca Borrelli2,
  3. Edzard Ernst3,
  4. Gabi Habacher4,
  5. Shao Kang Hung5,
  6. Stefania Milazzo1,
  7. Markus Horneber1

Editorial Group: Cochrane Gynaecological Cancer Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 3 APR 2009

DOI: 10.1002/14651858.CD005004.pub2


How to Cite

Boehm K, Borrelli F, Ernst E, Habacher G, Hung SK, Milazzo S, Horneber M. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD005004. DOI: 10.1002/14651858.CD005004.pub2.

Author Information

  1. 1

    Klinikum Nord, Medizinische Klinik 5-Schwerpunkt Onkologie/Haematologie, Nuernberg, Germany

  2. 2

    University of Naples 'Federico II', Department of Experimental Pharmacology, Naples, Italy

  3. 3

    Peninsula Medical School, University of Exeter, Complementary Medicine Department, Exeter, UK

  4. 4

    Small Animal Hospital, Feline Centre, Langford, UK

  5. 5

    Peninsula Medical School, Universities of Exeter and Plymouth, Complementary Medicine, Exeter, Devon, UK

*Katja Boehm, Medizinische Klinik 5-Schwerpunkt Onkologie/Haematologie, Klinikum Nord, Prof.-Ernst-Nathan-Str. 1, Nuernberg, D-90419, Germany. drkatjaboehm@googlemail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 8 JUL 2009

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Abstract

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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.

Objectives

To critically assess any associations between green tea consumption and the risk of cancer incidence and mortality.

Search 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.

Selection criteria

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.

Data collection and analysis

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.

Main 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.

Authors' 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.

 

Plain language summary

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Green tea for the prevention of cancer

Fifty-one studies with more than 1.6 million participants, mainly of observational nature were included in this systematic review. Studies looked for an association between green tea consumption and cancer of the digestive tract, gynecological cancer including breast cancer, urological cancer including prostate cancer, lung cancer and cancer of the oral cavity. The majority of included studies were of medium to high methodological quality. The evidence that the consumption of green tea might reduce the risk of cancer was conflicting. This means, that drinking green tea remains unproven in cancer prevention, but appears to be safe at moderate, regular and habitual use.

 

Plain language summary

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Zeleni čaj (Camellia sinensis) za prevenciju karcinoma

Zeleni čaj za prevenciju karcinoma

U sustavni pregled o učinku zelenog čaja na prevenciju karcinoma uključena je 51 studija s ukupno 1,6 milijuna ispitanika. Radilo se uglavnom o tzv. opažajnim studijama – u kojima istraživač ne odlučuje tko će biti izložen nekom utjecaju ili nekoj terapiji, nego samo promatra podatke o postojećem stanju. U analiziranim studijama je ispitana povezanost između pijenja zelenog čaja i karcinoma probavnog trakta, ginekoloških karcinoma uključujući i karcinom dojke, karcinoma mokraćnog sustava uključujući karcinom prostate, karcinoma pluća i karcinoma usne šupljine. Glavnina uključenih studija bile su srednje ili visoke metodološke kvalitete. Dokazi o tome može li konzumiranje zelenog čaja smanjiti rizik od karcinoma bili su proturječni. To znači da i dalje nema dokaza da je pijenje zelenog čaja korisno za prevenciju karcinoma. S druge strane uzimanje zelenog čaja nije bilo povezano s nuspojavama pa ga je sigurno konzumirati umjereno i redovito.

Translation notes

Translated by: Croatian Branch of the Italian Cochrane Centre 27th March, 2014
Translation Sponsored by: Ministry of Education, Science and Sports