The International Journal of Cancer (IJC)Hot Drinks and Oesophageal Cancer: Prospective Analyses in Around 1 Million UK Adults

ℹ️ Observational Association Only Evidence

Researchers pooled data from 977,282 participants in the Million Women Study and UK Biobank to examine hot-drink temperature and frequency in relation to esophageal cancer. During average follow-up periods of 14.2 and 11.1 years, respectively, 2,348 cancers occurred. Preference for very hot versus warm beverages was associated with greater squamous cell carcinoma risk, while no material association was observed for adenocarcinoma. The prospective design and consistent subtype-specific results strengthen the signal, but self-reported temperature and observational analysis limit causal interpretation.

Clinical Considerations

• Very hot versus warm beverage preference was associated with 3.17-fold higher SCC risk after adjustment for consumption frequency.
• Drinking at least six hot beverages daily was associated with 71% higher SCC risk after adjustment for temperature.
• Neither temperature nor consumption frequency showed a comparable association with esophageal adenocarcinoma.
• Results remained broadly consistent across assessed subgroups and after excluding the first five years of follow-up.
• Beverage type and milk addition did not materially alter the temperature-associated findings, supporting thermal exposure as a possible mechanism.
• Drink temperature was self-reported once, and absolute temperatures were not measured, limiting exposure precision and generalizability.

Practice Applications

• Recognize hot-beverage temperature and frequency as potential risk context for esophageal squamous cell carcinoma.
• Discuss beverage-temperature habits when counseling patients about modifiable esophageal cancer risk factors.
• Interpret the estimated preventable fraction cautiously because it assumes the observed association is causal.
• Avoid extrapolating the SCC findings to esophageal adenocarcinoma or defining a precise safe-temperature threshold.
• Consider smoking and alcohol exposure alongside thermal exposure during individualized risk assessment.