Hot Drinks and Oesophageal Cancer: Prospective Analyses in Around 1 Million UK Adults

Journal Article 1 Mention

Keren Papier•2026

Kezia L. GaitskellSarah Floud

Top 3% · 97th Percentile

1 citations · Surgery

Open AccessThe Million Women Study

TLDR

Having drinks that are very hot was linked to a higher chance of cancer in the food pipe. Drinking fewer hot drinks each day may also help lower that chance.

Summary

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1 Study Aim

The researchers examined whether the temperature and frequency of tea and coffee drinking were linked with oesophageal cancer, cancer of the food pipe. They focused on oesophageal squamous cell carcinoma (SCC), a cancer arising in the food pipe’s lining, and adenocarcinoma (AC), a gland-forming cancer. The authors aimed to identify practical ways to prevent these two cancer types. The study asked whether drink temperature and drinking frequency affected the chance of developing either type of food-pipe cancer.

2 Study Design

The researchers followed 977,282 adults in two UK prospective cohorts (groups followed forward over time): the Million Women Study and UK Biobank. Participants reported their usual drink temperature and hot-drink frequency. The researchers used Cox regression (a method comparing disease rates over time) to estimate relative risks (risk comparisons) and 95% confidence intervals (ranges showing uncertainty). Follow-up averaged 14.2 years in the Million Women Study and 11.1 years in UK Biobank. During follow-up, 2,348 participants developed oesophageal cancer, including 1,045 SCC and 1,303 AC. The authors combined results from both cohorts using a weighted average. The researchers tracked nearly one million adults and compared cancer rates according to drink temperature and frequency.

3 Findings

The study found that very hot rather than warm drinks were associated with about three times the risk of oesophageal squamous cell carcinoma (SCC). Relative risk (RR) was 3.17, with a 95% confidence interval (CI) of 2.49–4.03. Temperature was not associated with adenocarcinoma (AC), with RR 0.92 (CI 0.76–1.12). After accounting for temperature, six or more hot drinks daily were associated with 71% higher SCC risk than fewer than six. That pattern was much weaker for AC, with RR 1.19 (CI 1.06–1.33). The authors estimated that 14% of SCC cases could be avoided if very-hot drinks were replaced with hot drinks. They argue that cooler drinks might prevent more cases, because risk increased across temperature categories. Choosing cooler drinks and having fewer hot drinks each day may lower the chance of cancer in the food pipe.

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.

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