There is certainly epidemiological evidence showing that drinking green tea can lower the risk of esophageal cancer (EC). intakes of vegetables and fruitsLow or mild ( 60 C)1.0High (60 C)2.23 (1.45C2.90)Yang et al. br /  br / China br / 2018Population based case control study br / 1355/1962Never tea drinking1.00Adjusted for age, marital status, education, occupation, family wealth score, body mass index 10 years ago, sum of missing and filled teeth, number of tooth brushing per day, smoking pack-years, alcohol consumption intensity and family history of EC among first-degree relatives.Hot tea drinking2.15 (1.52C3.05)Yu et al. br /  br / China br / 2018Population based cohort study br FRP-2 / 456,155 participants Frequency * Adjusted for age, sex, education, marital status, household income, physical activity, intake of red meat, fresh fruits and vegetables and preserved vegetables, body mass index, family history of cancer, and tobacco smoking. br / *: Participants who consumed pure alcohol 15 g/day or didnt drink alcohol everyday br / **: Participants who consumed pure alcohol 15 g/day br / All of the data was calculated with participants who consumed tea less than weekly and consumed 15 g/d of pure alcohol as the reference category.Less Than Weekly1.00Weekly0.82 Manidipine 2HCl (0.57C1.18)Daily Warm0.92 (0.66C1.30)Hot1.23 (0.96C1.59)Burning hot1.36 (1.00C1.86) Frequency ** Less Than Weekly1.90 (1.57C2.31)Weekly2.60 (1.79C3.76)Daily Warm3.74 (2.86C4.90)Hot3.84 (3.06C4.83)Burning hot5.00 (3.64C6.88) Open in a separate window 3. Epidemiological Evidence Earlier researchers had declared that drinking green tea could suppress esophageal carcinogenesis (Table 2). Early in 1994, a population based case-control study launched in China had found that drinking green tea had a possible inhibitory effect on EC . The partnership between tea consuming and reduced EC risk was also verified by many case-control research [26,27], prospective cohort studies [28,29], and meta-analyses [30,31,32]. It was also shown that women were especially susceptible to the protective effect [25,31,32,33]. However, in epidemiological studies, the impact of lifestyle, differences of hereditary and other confounding factors can lower the confidence level of cancer preventive effect. Daily drinking tea 3 cups could increase the ESCC incidence rate . In addition, inconsistent results were observed when tea was consumed at different temperatures . It was reported that this EC risk increased because of the mucosal damage caused by large amounts of sipping, rapid eating and consumption of high temperature food [35,36]. In Manidipine 2HCl general, drinking a relatively high quantity of tea at low-temperature had a significantly preventive effect against EC, but the risk increased greatly if green tea was consumed at higher temperatures (70C79 C), OR = 2.21, 95%CI(1.57C5.53); above 80 C, OR = 4.74, 95%CI (2.6C10.51) . Another two strong interfering factors are cigarette smoking and alcohol drinking, which may hinder the Manidipine 2HCl suppressive effect of tea drinking on EC risk. Gao et al. carried out a case-control study in China and reported that this prevention effect was only found in persons who didnt smoke, among which most were females . Wu et al. also found a significant negative correlation between drinking green tea and the EC risk among the persons who never smoke or drank no alcohol . After adjusting for confounding factors, the preventive effect of drinking green tea on upper digestive tract cancer was obvious . The preventive efficacy of drinking green tea against EC may be neutralized by the strong side effects of alcohol drinking, smoking, or Manidipine 2HCl drinking high temperature beverages. Although most data extracted from epidemiological research and meta-analyses recommended that EGCG could play an optimistic role in tumor chemoprevention , there is inconsistent proof tea also.