Medical Mythbusting Commentary for September 11, 2026

Source:
Hot Beverages May Triple Your Risk of Developing a Certain Type of Cancer

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

The consumption of beverages at or above ~65°C (149°F) is linked to esophageal cancer, specifically esophageal squamous cell carcinoma (ESCC), and this association is driven by the temperature itself rather than the type of drink. The 65°C threshold you cite is exactly the cutoff the International Agency for Research on Cancer (IARC) used when it classified drinking “very hot beverages” (above 65°C) as a Group 2A “probably carcinogenic to humans” exposure.[1][2] Importantly, the link is consistently observed for the squamous cell subtype and not for esophageal adenocarcinoma.[3][4][5]

The effect is thermal, not beverage-specific. The carcinogenic signal has been demonstrated across tea, maté, coffee, and even hot foods and porridge — the common denominator is thermal injury to the esophageal mucosa, not a chemical constituent.[6] A margin-of-exposure analysis comparing polycyclic aromatic hydrocarbons (PAHs) against temperature found that PAH exposure from these drinks poses very low risk (MOE >100,000), whereas the temperature effect had an MOE <1, implicating heat as the operative mechanism.[7] Mechanistically, recurrent thermal injury is thought to increase susceptibility of the mucosa to other carcinogens and drive compensatory proliferation; drinking a 65°C beverage raises intra-esophageal temperature by 6–12°C depending on sip size.[8][9][2]

Key evidence supporting the 65°C threshold:

Study / source	Design	Key finding	References
Golestan Cohort (Iran)	Prospective, objectively measured tea temperature	ESCC HR 1.41 (1.10–1.81) for ≥60°C vs <60°C; HR 2.41 for “very hot” vs cold/lukewarm	[10]
Golestan case-control (Iran)	Population-based	Very hot tea vs warm: OR 8.16 (3.93–16.9); drinking <2 min after pouring: OR 5.41	[11]
China Kadoorie Biobank	Prospective, 456,155 adults	Burning-hot tea + alcohol ≥15 g/d: HR 5.00; burning-hot tea + smoking: HR 2.03 (risk mainly with concurrent alcohol/tobacco)	[12]
UK Biobank	Prospective, 454,796 adults	Very hot beverages ≤4 cups/d: ESCC HR 2.52 (1.27–5.03); no association with adenocarcinoma	[3]
UK Million Women Study + UK Biobank (~1M)	Pooled prospective	“Very hot” vs “warm” drinks: SCC RR 3.17 (2.49–4.03); no association with adenocarcinoma (RR 0.92)	[4]
ESCCAPE (Malawi/Tanzania)	Case-control	“Very hot” vs “hot”: OR 1.92; composite thermal score ≥9 vs 3: OR 4.6	[13]
Andrici & Eslick	Meta-analysis	Hot food/drink and ESCC: OR 2.29 (1.79–2.93), persisting after adjusting for tobacco/alcohol	[5]

Important caveats and areas of uncertainty:

– Coffee specifically shows no consistent adverse association, likely because it is typically consumed below 60°C in most populations; several studies suggest coffee may even be protective. The risk tracks temperature, so any beverage drunk hot enough carries it.[9]

– The historical evidence has been geographically uneven. A meta-analysis found significant associations in East Asian (OR 2.06) and South American (OR 1.52) populations but not European populations (OR 0.95), and some reviews previously considered the tea–ESCC link “uncertain” outside high-incidence regions like Iran and Kashmir. The very recent ~1-million-participant UK analysis strengthens the case in a Western population.[14][9][4]

– A Mendelian randomization study found no significant causal effect of hot beverage temperature preference on esophageal cancer in either European or East Asian populations, concluding genetic evidence for causation was insufficient — though self-reported “preference” is a coarse proxy for actual sip temperature.[15]

Practical takeaway: The convergent epidemiologic, mechanistic, and animal-model evidence supports allowing beverages to cool below ~60–65°C before drinking as a plausible, low-cost primary-prevention measure for ESCC; modestly lowering temperature (rather than abstaining) appears sufficient to reduce risk.[16][10][7]

Would you like to explore the cellular mechanisms by which thermal injury promotes esophageal squamous carcinogenesis?

References

1. Hot Beverage Consumption in the African Esophageal Cancer Corridor: A Community-Based Thermal Exposure Measurement Study Across the Lifespan. Menya D, Bouaoun L, Chepkomoi T, et al. Cancer Epidemiology. 2024;92:102614. doi:10.1016/j.canep.2024.102614.
2. Investigations concerning the impact of consumption of hot beverages on acute cytotoxic and genotoxic effects in oral mucosa cells. Ernst B, Setayesh T, Nersesyan A, et al. Scientific Reports. 2021;11(1):23014. doi:10.1038/s41598-021-01995-9.
3. Hot Beverage Intake and Oesophageal Cancer in the UK Biobank: Prospective Cohort Study. Inoue-Choi M, Ramirez Y, O’Connell C, et al. British Journal of Cancer. 2025;132(7):652-659. doi:10.1038/s41416-025-02953-2.
4. Hot Drinks and Oesophageal Cancer: Prospective Analyses in Around 1 Million UK Adults. Papier K, Gaitskell K, Floud S, Reeves GK. International Journal of Cancer. 2026;. doi:10.1002/ijc.70654.
5. Hot Food and Beverage Consumption and the Risk of Esophageal Cancer: A Meta-Analysis. Andrici J, Eslick GD. American Journal of Preventive Medicine. 2015;49(6):952-60. doi:10.1016/j.amepre.2015.07.023.
6. High-Temperature Beverages and Foods and Esophageal Cancer Risk–a Systematic Review. Islami F, Boffetta P, Ren JS, et al. International Journal of Cancer. 2009;125(3):491-524. doi:10.1002/ijc.24445.
7. Comparative Oesophageal Cancer Risk Assessment of Hot Beverage Consumption (Coffee, Mate and Tea): The Margin of Exposure of PAH vs Very Hot Temperatures. Okaru AO, Rullmann A, Farah A, et al. BMC Cancer. 2018;18(1):236. doi:10.1186/s12885-018-4060-z.
8. Oesophageal Cancer. Lagergren J, Smyth E, Cunningham D, Lagergren P. Lancet (London, England). 2017;390(10110):2383-2396. doi:10.1016/S0140-6736(17)31462-9.
9. Diet and Upper Gastrointestinal Malignancies. Abnet CC, Corley DA, Freedman ND, Kamangar F. Gastroenterology. 2015;148(6):1234-1243.e4. doi:10.1053/j.gastro.2015.02.007.
10. A Prospective Study of Tea Drinking Temperature and Risk of Esophageal Squamous Cell Carcinoma. Islami F, Poustchi H, Pourshams A, et al. International Journal of Cancer. 2020;146(1):18-25. doi:10.1002/ijc.32220.
11. Tea Drinking Habits and Oesophageal Cancer in a High Risk Area in Northern Iran: Population Based Case-Control Study. Islami F, Pourshams A, Nasrollahzadeh D, et al. BMJ (Clinical Research Ed.). 2009;338:b929. doi:10.1136/bmj.b929.
12. Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study. Yu C, Tang H, Guo Y, et al. Annals of Internal Medicine. 2018;168(7):489-497. doi:10.7326/M17-2000.
13. A Very-Hot Food and Beverage Thermal Exposure Index and Esophageal Cancer Risk in Malawi and Tanzania: Findings From the ESCCAPE Case-Control Studies. Masukume G, Mmbaga BT, Dzamalala CP, et al. British Journal of Cancer. 2022;127(6):1106-1115. doi:10.1038/s41416-022-01890-8.
14. Updated epidemiology of gastrointestinal cancers in East Asia. Huang J, Lucero-Prisno DE, Zhang L, et al. Nature Reviews. Gastroenterology & Hepatology. 2023;20(5):271-287. doi:10.1038/s41575-022-00726-3.
15. The Causal Effect of Hot Beverage Temperature Preference on Esophageal Cancer Risk: A Mendelian Randomization Study. Zhu M, Wei M, Huang S, Pan X. Journal of Thoracic Disease. 2024;16(8):4852-4862. doi:10.21037/jtd-24-361.
16. Epidemiology of Esophageal Squamous Cell Carcinoma. Abnet CC, Arnold M, Wei WQ. Gastroenterology. 2018;154(2):360-373. doi:10.1053/j.gastro.2017.08.023.