Is temperature an effect modifier of the association between green tea intake and gastric cancer risk?

We considered the relationship between green tea and gastric cancer risk in Harbin, Heilongjiang province, Northeast China, an area with high baseline risk of stomach cancer. We used data from a case-control study conducted from 1987 to 1989 among 266 incident cases of stomach cancer and 533 controls admitted to the same hospitals as cases, with non-neoplastic and non-gastric diseases. No association emerged when tea consumption alone was considered: the odds ratio (OR) for green tea consumption was 0.87 (95% CI: 0.60-1.25) for green tea intake > or = 750 g/year versus no intake and 0.99 (95% CI: 0.97-1.02) for an increment of 500 g of tea per year. When tea consumption was classified according to the temperature, however, the OR was 0.19 (95% CI: 0.07-0.49) for lukewarm tea intake > or = 750 g/year and 1.27 (95% CI: 0.85-1.90) for hot tea intake (P value for interaction <0.001) as compared with non-drinkers. The corresponding ORs for an increment of 500 g of tea per year were 0.61 (95% CI: 0.45-0.82) and 1.03 (95% CI: 0.99-1.07) for lukewarm and hot tea, respectively (P value for interaction <0.001). We found an inverse relationship between green tea drinking and gastric cancer risk limited to the intake of lukewarm tea.