Almost every dietary choice has been tied to a higher cancer risk at some point in the past. Drinking hot beverages has been linked to an increased risk of esophageal cancer in recent years.

This is mostly due to a World Health Organization (WHO) statement from 2016 and a Chinese study published in the Annals of Internal Medicine in February 2018 and another study published in 2019.

Why did hot drinks seem to raise the risk of esophageal cancer?

According to Dr. Daniela Molena, Director of Memorial Sloan Kettering’s Esophageal Surgery Program, this theory isn’t new. It dates back to the 1930s at the very least. Theoretically, hot liquid might harm the inner lining of the esophagus, forcing the cells to rebuild constantly. There’s a higher probability that something will go wrong and change normal cells into cancer cells throughout this procedure.

A long time ago, some animal studies revealed that really hot liquids could cause this harm. However, this was at a greater temperature than most people would drink beverages at.

Furthermore, if this type of damage caused esophageal cancer, a larger incidence of mouth cancer would be expected because the mouth lining is exposed to the liquid first – which does not occur.

What did all three study claim?

According to the doctor, both 2016 and 2018 papers were a bit misleading, at least as it applies to people in the United States and Europe. The type of esophageal cancer that is far more common in the United States is adenocarcinoma. The supposed link with hot beverages is related to esophageal cancer called squamous cell cancer. This type is prevalent in many other parts of the world — China, other parts of Asia, India, South America, and Africa — but is rare in the United States and Europe.

Even for squamous cell cancer, the evidence is not clear. In both cases, the suggested link was between squamous cell esophageal cancer and consumption of very hot tea. The WHO statement was based on a study looking at people who drank a variety of hot tea consumed in these other countries. These populations tend to have more exposure to other factors that raise the risk of cancer, such as smoking, alcohol consumption, cooking over an open fire, and environmental contaminants. The presence of these other factors makes it hard to be certain that hot tea alone was responsible for the increased risk.

The China study had a similar issue. It found a higher incidence of esophageal cancer in people who drank more hot tea but only in those who also drank alcohol every day or smoked. It is plausible that drinking hot beverages might raise esophageal cancer risk if combined with smoking or alcohol consumption. But the study did not find that hot tea alone had that effect.

Another problem with the China study was that it asked people to rank for themselves how hot the tea that they drank was. There was no actual measure of temperature. What one person may consider “very hot” may not hold true for someone else. In that sense, it’s really not a very scientifically rigorous study.

The 2019 study published in the International Journal of Cancer also found an association between hot tea consumption and esophageal squamous cell cancer.

According to Dr. Molena, this study was conducted in a specific region of Iran, which does not contradict the conclusions discussed in the story above.

“In this case, the temperature of the tea was actually measured rather than estimated by the individuals, which is a strength of the study. The weakness of the study is that most people in this region drink tea and there isn’t a control group available. The higher rate of esophageal cancer might be due to other environmental factors rather than tea temperature.”

What should people remember about hot beverages and esophageal cancer?

There has never been solid evidence that drinking hot liquids alone will increase esophageal cancer risk. At this point, we have only the suggestion that it might make the risk higher in people who smoke or consume alcohol.

“I would advise people to focus instead on factors that are very solidly linked to a higher risk of developing esophageal cancer. For squamous cell, it’s smoking and alcohol. For adenocarcinoma, the most common risk factors are obesity and gastroesophageal reflux disease.”

In short: Cut down on these other habits and drink all the reasonably hot liquids you want.

Image Credit: Getty

You were reading: Facts About Hot Drinks and Esophageal Cancer Risk, According to Doctor