A new study has revealed a direct connection between consuming very hot beverages and an increased likelihood of developing esophageal squamous cell carcinoma, a cancer type affecting the esophagus. Conducted by researchers at the University of Oxford, the investigation examined data from over 977,000 middle-aged adults in the U.K., monitoring their drinking habits across nearly 14 years. During this period, 2,348 participants received diagnoses of esophageal cancer, with the analysis uncovering a clear trend: the higher the drink temperature, the greater the associated risk.
This relationship between hot drinks and esophageal cancer has been documented before. A prior review of 59 separate studies, also published in the International Journal of Cancer, determined that hot beverages appear linked to an increased cancer risk. The American Cancer Society has since included “frequently drinking very hot liquids” among the recognized risk factors for squamous cell esophageal cancer.
The precise biological mechanism remains under study, though experts suggest repeated thermal damage as the primary explanation. Keren Papier, PhD, the study’s lead author and a nutritional epidemiologist, notes that very hot liquids may damage the cells lining the esophagus, increasing vulnerability to cancerous changes over time. Cindy Pabon, MD, a gastrointestinal medical oncologist, adds that while occasional warm drinks pose minimal risk, daily exposure to extreme heat can trigger chronic inflammation—a known precursor to cancer development.
Jaffer A. Ajani, MD, a gastrointestinal oncology researcher, emphasizes that the harm accumulates gradually. “If you do it once, it can heal up, and you can be fine,” he says. “But if you do it two, three times a day for several years, you’re burning that area over and over again.” That can lead to chronic inflammation, he says. “Then, you’re inviting cancer,” Dr. Ajani says.
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The study did not directly compare iced beverages to hot ones, though experts suggest cooler temperatures may carry lower risks. Ajani cautions, however, that extremely cold drinks could also cause tissue damage, meaning moderation remains essential. Researchers recommend allowing hot drinks to cool slightly before consumption as the safest approach.
The International Agency for Research on Cancer (IARC) advises keeping beverages below 149°F (65°C), as anything hotter falls into the “probably carcinogenic” category. Without a thermometer, Pabon offers a practical test: if a drink burns the mouth or requires a sleeve to hold, it is likely too hot. A simpler guideline is waiting until the beverage cools enough to hold a fingertip in it for several seconds.
Papier confirms this method as effective, stating that a simple adjustment, letting hot drinks cool before drinking, can reduce risk. The study’s findings align with broader safety guidelines, though the exact temperature threshold for risk remains under investigation.
Beyond temperature, the study identified frequency as a critical factor. Those who drank six or more hot beverages daily saw a 71% higher risk of esophageal squamous cell carcinoma. Researchers noted that the damage is not immediate but develops over years, as repeated thermal stress weakens the esophageal lining. Pabon explained that while occasional hot drinks may cause minor irritation, daily exposure creates a damaging cycle of injury and inflammation, which can eventually lead to cancerous tissue changes.