Breast Cancer Research and Treatment

, Volume 124, Issue 3, pp 827–834

Plasma tea polyphenol levels and subsequent risk of breast cancer among Japanese women: a nested case–control study

  • Motoki Iwasaki
  • Manami Inoue
  • Shizuka Sasazuki
  • Tsutomu Miura
  • Norie Sawada
  • Taiki Yamaji
  • Taichi Shimazu
  • Walter C. Willett
  • Shoichiro Tsugane


Although many in vitro and animal studies have suggested a protective effect of green tea against breast cancer, findings from epidemiological studies have been inconsistent. No study has used prediagnostic biomarkers of tea polyphenols, which might play a protective role. A total of 24,226 women aged 40 to 69 years in the Japan Public Health Center-based Prospective Study who responded to the baseline questionnaire and provided blood in 1990–1995 were followed to December 2002. During a mean 10.6 years of follow-up, 144 newly diagnosed breast cancers were identified. Two matched controls for each case were selected from the cohort. Plasma levels of (-)-epigallocatechin (EGC), (-)-epicatechin (EC), (-)-epigallocatechin-3-gallate (EGCG), and (-)-epicatechin-3-gallate (ECG) were measured, and the odds ratio (OR) of breast cancer according to plasma level was estimated using a conditional logistic regression model. We found no statistically significant association between plasma tea polyphenol levels and breast cancer risk. Adjusted ORs for the highest versus lowest group were 0.90 (95% CI 0.42–1.96; P for trend = 0.98) for EGC, 0.95 (95% CI 0.43–2.08; P for trend = 0.86) for EC, 1.21 (95% CI 0.52–2.80; P for trend = 0.53) for EGCG, and 1.75 (95% CI 0.81–3.78; P for trend = 0.15) for ECG. Stratified analyses according to baseline menopausal status showed no remarkable difference between two strata. This nested case–control study found no overall association between plasma tea polyphenols and the risk of breast cancer in Japan.


Breast cancer Plasma tea polyphenol (-)-Epigallocatechin-3-gallate Nested case–control study 



Body mass index


Confidence interval










Food frequency questionnaire

JPHC Study

Japan Public Health Center-based Prospective Study


Odds ratio


Public health centers


  1. 1.
    Cabrera C, Artacho R, Gimenez R (2006) Beneficial effects of green tea—a review. J Am Coll Nutr 25:79–99PubMedGoogle Scholar
  2. 2.
    Schneider C, Segre T (2009) Green tea: potential health benefits. Am Fam Physician 79:591–594PubMedGoogle Scholar
  3. 3.
    Curado MP, Edwards B, Shin HR et al (2007) Cancer incidence in five continents, vol IX. IARC Scientific Publications No. 160. IARC, LyonGoogle Scholar
  4. 4.
    Yang CS, Lambert JD, Sang S (2009) Antioxidative and anti-carcinogenic activities of tea polyphenols. Arch Toxicol 83:11–21CrossRefPubMedGoogle Scholar
  5. 5.
    Crespy V, Williamson G (2004) A review of the health effects of green tea catechins in in vivo animal models. J Nutr 134:3431S–3440SPubMedGoogle Scholar
  6. 6.
    Satoh K, Sakamoto Y, Ogata A et al (2002) Inhibition of aromatase activity by green tea extract catechins and their endocrinological effects of oral administration in rats. Food Chem Toxicol 40:925–933CrossRefPubMedGoogle Scholar
  7. 7.
    Komori A, Yatsunami J, Okabe S et al (1993) Anticarcinogenic activity of green tea polyphenols. Jpn J Clin Oncol 23:186–190PubMedGoogle Scholar
  8. 8.
    Shrubsole MJ, Lu W, Chen Z et al (2009) Drinking green tea modestly reduces breast cancer risk. J Nutr 139:310–316PubMedGoogle Scholar
  9. 9.
    Zhang M, Holman CD, Huang JP et al (2007) Green tea and the prevention of breast cancer: a case-control study in Southeast China. Carcinogenesis 28:1074–1078CrossRefPubMedGoogle Scholar
  10. 10.
    Wu AH, Yu MC, Tseng CC et al (2003) Green tea and risk of breast cancer in Asian Americans. Int J Cancer 106:574–579CrossRefPubMedGoogle Scholar
  11. 11.
    Nagano J, Kono S, Preston DL et al (2001) A prospective study of green tea consumption and cancer incidence, Hiroshima and Nagasaki (Japan). Cancer Causes Control 12:501–508CrossRefPubMedGoogle Scholar
  12. 12.
    Suzuki Y, Tsubono Y, Nakaya N et al (2004) Green tea and the risk of breast cancer: pooled analysis of two prospective studies in Japan. Br J Cancer 90:1361–1363CrossRefPubMedGoogle Scholar
  13. 13.
    Inoue M, Robien K, Wang R et al (2008) Green tea intake, MTHFR/TYMS genotype and breast cancer risk: the Singapore Chinese Health Study. Carcinogenesis 29:1967–1972CrossRefPubMedGoogle Scholar
  14. 14.
    Watanabe S, Tsugane S, Sobue T et al (2001) Study design and organization of the JPHC study. J Epidemiol 11(Suppl 6):S3–S7Google Scholar
  15. 15.
    Lee MJ, Wang ZY, Li H et al (1995) Analysis of plasma and urinary tea polyphenols in human subjects. Cancer Epidemiol Biomarkers Prev 4:393–399PubMedGoogle Scholar
  16. 16.
    Lee MJ, Prabhu S, Meng X et al (2000) An improved method for the determination of green and black tea polyphenols in biomatrices by high-performance liquid chromatography with coulometric array detection. Anal Biochem 279:164–169CrossRefPubMedGoogle Scholar
  17. 17.
    Lee MJ, Maliakal P, Chen L et al (2002) Pharmacokinetics of tea catechins after ingestion of green tea and (-)-epigallocatechin-3-gallate by humans: formation of different metabolites and individual variability. Cancer Epidemiol Biomarkers Prev 11:1025–1032PubMedGoogle Scholar
  18. 18.
    Sasazuki S, Inoue M, Miura T et al (2008) Plasma tea polyphenols and gastric cancer risk: a case-control study nested in a large population-based prospective study in Japan. Cancer Epidemiol Biomarkers Prev 17:343–351CrossRefPubMedGoogle Scholar
  19. 19.
    Tsubono Y, Kobayashi M, Sasaki S et al (2003) Validity and reproducibility of a self-administered food frequency questionnaire used in the baseline survey of the JPHC Study Cohort I. J Epidemiol 13(Suppl 1):S125–S133Google Scholar
  20. 20.
    Sasaki S, Ishihara J, Tsugane S (2003) Reproducibility of a self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC Study Cohort I to assess food and nutrient intake. J Epidemiol 13(Suppl 1):S115–S124Google Scholar
  21. 21.
    Ferlay J, Bray F, Pisani P et al (2004) GLOBOCAN 2002 cancer incidence, mortality and prevalence worldwide, IARC CancerBase No. 5, version 2.0. IARC Press, LyonGoogle Scholar
  22. 22.
    Iwasaki M, Yamamoto S, Otani T et al (2006) Generalizability of relative risk estimates from a well-defined population to a general population. Eur J Epidemiol 21:253–262CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Motoki Iwasaki
    • 1
  • Manami Inoue
    • 1
  • Shizuka Sasazuki
    • 1
  • Tsutomu Miura
    • 1
    • 2
  • Norie Sawada
    • 1
  • Taiki Yamaji
    • 1
  • Taichi Shimazu
    • 1
  • Walter C. Willett
    • 3
    • 4
  • Shoichiro Tsugane
    • 1
  1. 1.Epidemiology and Prevention DivisionResearch Center for Cancer Prevention and Screening, National Cancer CenterTokyoJapan
  2. 2.Department of Health and Nutrition, Faculty of Human LifeJin-ai UniversityEchizenJapan
  3. 3.Departments of Nutrition and EpidemiologyHarvard School of Public HealthBostonUSA
  4. 4.Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital Harvard Medical SchoolBostonUSA

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