Summary:
This large prospective cohort study looked at data from two UK cohorts involving almost one million participants to investigate whether drink temperature and frequency of hot tea and coffee consumption were associated with the risk of esophageal squamous cell carcinoma (SCC) and adenocarcinoma (AC), as previous studies have reported higher rates of esophageal cancer among people who regularly consume beverages at very high temperatures. The evidence suggests that the increased cancer risk is related to thermal injury from the high temperature of the drink rather than the beverage itself. This study followed participants for 11-14 years and identified 2,348 cases of oesophageal cancer. Statistical analyses were used to estimate the association between drink temperature, consumption frequency, and cancer risk. Participants who reported drinking beverages at a very hot temperature had more than three times the risk of developing SCC compared with those who preferred warm drinks. In contrast, no association was observed between very hot drink consumption and AC. Independent of drink temperature, consuming six or more hot drinks per day was also associated with a higher risk of SCC, while the association with AC was weak. Overall, the findings show that both drink temperature and frequent consumption of hot beverages are important risk factors for esophageal SCC. The authors estimated that a substantial proportion of SCC cases could potentially be prevented if very hot drinks were consumed at lower temperatures. These results support reducing the temperature of hot beverages as a potential strategy for lowering SCC risk in populations where tea and coffee consumption is common.
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Abstract:
Studies in Asia, Africa, South America and the Middle East have consistently shown that tea or mate drunk at very high temperatures (~70°C) increases oesophageal cancer risk, but evidence is limited for drink temperatures typical of Western populations. In analyses of two large UK cohorts (977,282 participants), we used Cox regression to estimate hazard ratios (hereafter referred to as RRs) and 95% confidence intervals (CIs) for oesophageal cancer subtypes by self-reported preferred drink temperature, our primary focus and frequency of hot drink (tea and coffee) consumption. Pooled estimates were calculated using inverse-variance-weighted averages of cohort-specific log RRs. During an average follow-up of 14.2 years (Million Women Study [MWS]) and 11.1 years (United Kingdom Biobank [UKB]), 2348 incident oesophageal cancers occurred (1045 squamous cell carcinoma [SCC], 1303 adenocarcinoma [AC]). Consumption of drinks at a ‘very hot’ versus ‘warm’ temperature was associated with a 3-fold greater SCC risk (RR = 3.17 [95% CI: 2.49, 4.03]) but not with AC risk (0.92 [0.76, 1.12]), after adjustment for consumption frequency. After controlling for drink temperature, daily consumption of 6+ versus < 6 hot drinks was associated with a 71% increase in SCC risk (1.71 [1.51, 1.94]), with little association with AC risk (1.19 [1.06, 1.33]). In UK adults, an estimated 14% of SCC oesophageal cancers could be avoided if individuals who reported consuming their drinks at a ‘very hot’ temperature instead consumed them at a temperature more representative of the temperature range described here as ‘hot’. The fact that we observed a clear trend in risk across self-reported temperature categories suggests that further limiting the temperature at which individuals consume their drinks to something well below average for this population may well avoid an even greater proportion of SCC cases. This large UK study of middle-aged adults, amongst whom hot drinks are widely consumed, provides clear evidence that temperature and frequency of hot drink consumption represent useful targets for oesophageal SCC prevention.
Article Publication Date: 08/09/2026
DOI: 10.1002/ijc.70654
