In a case -control study of 107 adults with leukaemia and 110 orthopaedic controls in China, a reduced risk was found with longer duration, higher quantity, and frequency of green tea intake. Tea is one of the most frequently consumed beverages in the world (Graham, 1992). Different processing of tea leaves yields green, black, or Oolong tea. If tea leaves are immediately heated, then the enzymes that oxidise catechins are inactivated and the result is green tea; if crushed and allowed to undergo enzyme-mediated oxidation, the process results in black tea with its characteristic colour and taste. Oolong tea results from partially oxidised tea leaves (Graham, 1992).There is some evidence of a protective effect of green tea consumption on certain cancers (Zhang et al, 2002;2004;2007;Cabrera et al, 2006), but no epidemiological data are available on the effect of green tea on adult leukaemia. We therefore conducted a case -control study of the question in southeast China.
MATERIALS AND METHODSA hospital-based case -control study was conducted in Hangzhou, southeast China. Eligible cases were defined as Chinese, over 15 years old and resident in Zhejiang Province with leukaemia, histopathologically confirmed according to the haematological standards (Zhang, 1998). They were identified by daily searching of medical records in haematology wards at two teaching hospitals of Zhejiang University in 2005 -2006; all medical records and laboratory reports were also reviewed to ensure complete ascertainment of cases. A total of 107 patients aged 16 -81 years were recruited, most (83.2%) were recent and were interviewed within 12 months of diagnosis. During the same period of data collection, 110 orthopaedic patients without leukaemia or other malignancy were randomly selected as controls to match the cases by age using a daily update of the list of cases. The project received approval from the hospital authorities and from the Human Research Ethics Committee of The University of Western Australia.Subjects were briefed regarding the aims of the study and confidentiality issues. After obtaining their consent, a face-to-face interview was conducted in the hospitals using a structured, validated questionnaire on (a) demography and lifestyle; (b) tea consumption; (c) hazard exposure and family history of malignancy. Most cases were recent patients interviewed within 3 -6 months of diagnosis. Details of leukaemia subtype and stage were retrieved from hospital records.Tea consumption was measured using a questionnaire adapted from our previous studies, its reproducibility evaluated in a testretest study where the intraclass correlation coefficient was 0.83 for tea (Zhang et al, 2005). Information was sought on preparation method, type of tea drank, duration of each type, frequency of cups (350 -400 ml), frequency of new batches of tea brewed, quantity of dried tealeaf consumed per year (in liang, equivalent to 50 g), and date of cessation. Frequency of cups was categorised as never or seldom, once a month, 2-3 times a month, once a...