Higher preferred drink temperature and more frequent hot drink consumption were each associated with greater risk of esophageal squamous cell carcinoma in nearly 1 million UK adults, according to a prospective cohort study published in the International Journal of Cancer. Researchers found no evidence of an association between preferred drink temperature and esophageal adenocarcinoma risk.
Researchers analyzed 977,282 participants from the Million Women Study and UK Biobank, including 510,112 participants from the Million Women Study and 467,170 from UK Biobank. The Million Women Study recruited women in England and Scotland, while UK Biobank recruited men and women in England, Wales, and Scotland. Participants reported their preferred hot drink temperature as warm, hot, or very hot, and how many cups of tea and coffee they consumed daily. Total consumption was categorized as fewer than 6 or 6 or more hot drinks per day.
Cox proportional hazards regression was used to estimate relative risks of esophageal squamous cell carcinoma and adenocarcinoma according to preferred drink temperature. Study-specific estimates were pooled using inverse-variance weighting. Analyses also assessed consumption frequency within temperature categories and mutually adjusted temperature and frequency to estimate their independent associations.
During mean follow-up of 14.2 years in the Million Women Study and 11.1 years in UK Biobank, 2,348 incident esophageal cancers occurred, including 1,045 squamous cell carcinomas and 1,303 adenocarcinomas. Approximately 43% of Million Women Study participants and 44% of UK Biobank participants consumed 6 or more hot drinks daily, while 13% and 17%, respectively, preferred very hot drinks.
After adjustment for consumption frequency, preference for very hot drinks was associated with more than 3 times the risk of squamous cell carcinoma compared with warm drinks, while preference for hot drinks was associated with approximately 1.7 times the risk. After adjustment for drink temperature, consumption of 6 or more hot drinks daily was associated with a 71% greater risk of squamous cell carcinoma compared with consuming fewer than 6. For adenocarcinoma, high drink frequency (6 or more cups daily) was associated with a modest pooled relative risk of 1.19, whereas preferred temperature showed no association (relative risk of 0.92 for very hot drinks).
Researchers found no evidence of interaction between preferred drink temperature and consumption frequency for either histologic subtype. Incremental adjustment for potential confounders did not materially alter the associations with squamous cell carcinoma, and findings were broadly similar during the first 5 years and at 5 or more years following baseline.
“Our findings suggest that reducing drink temperature in populations where tea and coffee are frequently consumed could offer an important means of SCC prevention,” wrote lead author Keren Papier of the Cancer Epidemiology Unit, Nuffield Department of Population Health, at the University of Oxford in Oxford, UK, and colleagues.
The researchers noted that preferred drink temperature was self-reported rather than directly measured and that temperature and intake were assessed at a single time point. They also noted that subjective perceptions of temperature may vary between populations, among participants, and over time.
The Million Women Study received funding from Cancer Research UK and the UK Medical Research Council. Keren Papier received fellowship support from the Nuffield Department of Population Health at the University of Oxford, and Kezia Gaitskell received support from a UK Research and Innovation Future Leaders Fellowship. The funders were not involved in the study design, data collection or analysis, publication decision, or manuscript preparation. The investigators reported no conflicts of interest.
Source: International Journal of Cancer
