In recent years, concerns have arisen about whether consuming very hot beverages—like tea, coffee, or traditional drinks such as maté—could increase the risk of cancer. The primary focus has been on esophageal cancer, particularly esophageal squamous cell carcinoma (ESCC). According to the International Agency for Research on Cancer (IARC), part of the World Health Organization, drinking beverages at temperatures above 65°C (149°F) is classified as “probably carcinogenic to humans” (Group 2A). This classification, established in 2016 and supported by ongoing research, emphasizes that it’s the heat itself, not the type of drink, that poses the potential risk.

The Science Behind the Link

The concern stems from thermal injury. Repeated exposure to scalding-hot liquids can damage the delicate lining of the esophagus, causing inflammation and increased cell turnover. Over time, this may promote mutations that lead to cancer. Animal studies have shown that hot water can accelerate precancerous changes, and human epidemiological data supports a biological plausibility.

Evidence has long come from regions where very hot drinks are cultural staples:

• In South America, consuming maté at high temperatures has been associated with elevated ESCC rates.
• Similar patterns appear in parts of Iran, China, and East Africa, where very hot tea or other beverages are common.

A landmark 2025 prospective cohort study from the UK Biobank, involving nearly 455,000 adults followed for over a decade, provided new insights relevant to Western populations. Researchers found that preferring “very hot” tea or coffee (self-reported) and consuming higher daily amounts was linked to significantly higher ESCC risk. For instance:

• Drinking more than 8 cups of very hot beverages daily was associated with about 5.6 times the risk compared to those preferring warm or no hot drinks.
• Even “hot” (not very hot) preferences showed increased risk with higher intake, in a dose-dependent manner.

Importantly, no clear association was found with esophageal adenocarcinoma (EAC), the more common type in many Western countries, often linked to obesity and acid reflux instead.

Other recent studies, including case-control research in East Africa (ESCCAPE studies) and meta-analyses, reinforce these findings, showing risks up to 4-5 times higher with habitual very hot consumption metrics like short waiting times, fast drinking, or frequent mouth burns.

How Hot Is Too Hot?

The IARC threshold is beverages above 65°C. Many freshly brewed coffees or teas start hotter than this, but they cool quickly. The risk appears tied to habitual consumption of scalding drinks—those hot enough to burn the mouth or throat—rather than occasional sips.

Practical factors influencing risk include:

• Sip size and speed: Larger, quicker sips raise intra-esophageal temperatures more.
• Frequency and volume: Higher daily intake amplifies exposure.

Who Faces the Greatest Risk?

The absolute risk remains low for most people, as ESCC is relatively rare in low-incidence areas like the US and Europe. However, risks are amplified when very hot drinks are combined with major factors like smoking or heavy alcohol use—sometimes multiplying odds dramatically.

In high-incidence regions (parts of Asia, Africa, and South America), hot beverages contribute more substantially to the cancer burden alongside other risks like poor nutrition or tobacco.

Broader Context and Benefits of Beverages

Moderately warm tea and coffee are not implicated and may offer health benefits, such as reduced risks for liver cancer, type 2 diabetes, and overall mortality due to antioxidants and other compounds.

No strong evidence links hot drinks to stomach, throat, or other cancers beyond ESCC.

Simple Steps to Reduce Risk

The good news is that this is an avoidable factor. Experts recommend:

• Letting beverages cool for a few minutes before drinking—aim below 65°C.
• Taking smaller sips and drinking more slowly.
• Prioritizing proven prevention: Quit smoking, limit alcohol, maintain a healthy weight, and manage reflux.

If you experience persistent heartburn, swallowing difficulties, or other symptoms, consult a doctor. While the evidence is consistent and growing, focusing on temperature is a straightforward way to enjoy your favorite drinks more safely.

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