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Drinking hot tea linked to esophageal cancer

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The results of a population-based case-control study showed that the consumption of hot or very hot tea and drinking tea within a few minutes of pouring were strongly associated with the development of squamous cell carcinoma of the esophagus.

Researchers recruited 300 patients with esophageal cancer and 571 healthy participants in the Golestan province of northern Iran. The mean volume of black tea consumption was more than one liter per day and 98% of those in the study regularly drank black tea.

Compared with drinking warm or lukewarm tea, those who drank hot tea had an OR of 2.07 for developing esophageal cancer (95% CI, 1.28-3.35). The association was even stronger for those who drank very hot tea (OR=8.16; 95% CI, 3.93-16.91).

The researchers found that the sooner drinkers consumed their tea after pouring, the greater their risk for disease. Those who waited two to three minutes after pouring had an OR of 2.49 (95% CI, 1.62-3.83) compared with an OR of 5.41 for those who waited less than two minutes (95% CI, 2.63-11.14).

The researchers did not find a clear correlation between disease and amount of black tea consumed but said the trend test was statistically significant. They added that there was no statistically significant association between frequency of green tea consumption and esophageal cancer.

David C. Whiteman, PhD, National Health and Medical Research Council research fellow with Queensland Institute of Medical Research at Royal Brisbane Hospital in Australia, wrote in an accompanying editorial that the results showed temperatures >70° C were associated with a marked increase in risk for disease. He added that these results “were the most compelling to date” supporting the hypothesis that thermal injury to the esophagus leads to squamous cell carcinoma, though that has yet to be demonstrated conclusively.

“It is difficult to imagine any adverse consequences of waiting at least four minutes before drinking a cup of freshly boiled tea or more generally allowing foods and beverages to cool from ‘scalding’ to ‘tolerable’ before swallowing,” Whiteman wrote. “These findings are not cause for alarm, however, and they should not reduce public enthusiasm for the time-honored ritual of drinking tea.”

Islami F. BMJ. 2009;doi:10.1136/bmj.b929.