Very hot drinks linked to threefold rise in oesophageal squamous cancer risk

A major pooled analysis from Oxford researchers has found a clear link between drinking very hot beverages and an increased risk of esophageal squamous cell carcinoma. The work combined data from the Million Women Study and the UK Biobank and included 977,282 participants, making it the largest investigation of temperature and cancer to date.

Temperature, frequency and the size of the effect

According to the analysis published in the International Journal of Cancer, people who reported usually drinking "very hot" beverages had a 3.17 times higher risk of developing esophageal squamous cell carcinoma compared with those who drank their drinks warm. Those who said they usually drank drinks that were "hot" (but not extremely hot) had a 69% greater risk compared with people drinking moderately warm beverages.

Frequency also mattered: consuming six or more cups of a hot drink per day was associated with a 71% higher risk of this cancer, independently of preferred temperature.

Researchers emphasise that it is the thermal injury — not the drink itself — that appears to drive the association. Repeated exposure to very high temperatures can cause microburns and chronic inflammation of the oesophageal lining; over time, the cycle of injury and repair raises the chance of genetic errors that may lead to malignant changes.

The International Agency for Research on Cancer (IARC) — part of the World Health Organization — already classified beverages consumed at temperatures above 65 °C as "probably carcinogenic to humans" (Group 2A) in 2016. The new Oxford analysis shows the same risk is present in Western drinking habits, not only in regions with traditional very-hot tea customs.

Practical steps to reduce risk are simple: let a freshly made cup cool for 3–5 minutes before the first sip; add cold milk or a splash of cold water to drop the temperature below about 60 °C; and pay attention to any burning sensations on the tongue, lips or throat as a sign the drink is still too hot. Experts remind the public that smoking and heavy alcohol use remain the primary causes of this cancer type.

"You don't have to give up your favourite coffee or tea, just wait a few minutes for the drink to cool slightly before taking the first sip. The important thing is to avoid regularly drinking beverages so hot that they can scald your mouth or throat," said Dr Keren Papier, a nutritional epidemiologist at Oxford.

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