Consumption of hot beverages and foods and the risk of esophageal cancer: a meta-analysis of observational studies

Abstract

BackgroundPrevious studies have mostly focused on the effects of specific constituents of beverages and foods on the risk of esophageal cancer (EC). An increasing number of studies are now emerging examining the health consequences of the high temperature of beverages and foods. We conducted a meta-analysis to summarize the evidence and clarify the association between hot beverages and foods consumption and EC risk.MethodsWe searched the PubMed, Embase, and Web of Science databases for relevant studies, published before May 1, 2014, with the aim to estimate the association between hot beverage and food consumption and EC risk. A random-effect model was used to pool the results from the included studies. Publication bias was assessed by using the Begg test, the Egger test, and funnel plot.ResultsThirty-nine studies satisfied the inclusion criteria, giving a total of 42,475 non-overlapping participants and 13,811 EC cases. Hot beverage and food consumption was significantly associated with EC risk, with an odds ratio (OR) of 1.82 (95% confidence interval [CI], 1.53–2.17). The risk was higher for esophageal squamous cell carcinoma, with a pooled OR of 1.60 (95% CI, 1.29–2.00), and was insignificant for esophageal adenocarcinoma (OR: 0.79; 95% CI: 0.53–1.16). Subgroup analyses suggests that the association between hot beverage and food consumption and EC risk were significant in Asian population (OR: 2.06; 95% CI: 1.62-2.61) and South American population (OR: 1.52; 95% CI: 1.25-1.85), but not significant in European population (OR: 0.95; 95% CI: 0.68-1.34).ConclusionsHot beverage and food consumption is associated with a significantly increased risk of EC, especially in Asian and South American populations, indicating the importance in changing people’s dietary habits to prevent EC.

Oesophageal cancer

“…12 Among dietary factors, fruit and vegetable intake is protective, 13 while intake of red meat 14 and very hot beverages are risk factors. 15 Genetic factors are also involved; a pooled analysis of three genome-wide association studies found new susceptibility loci for OSCC. 16 Tobacco smoking cessation is probably the single most effective primary preventive measure.…”

Heat‐induced inflammation and its role in esophageal cancer

“…A mild increase in temperature (37–41°C) creates a significant disturbance to these junctions, leading to increased epithelial permeability . A deficient barrier caused by heat increases the risk of esophageal damage by subsequent contact with refluxed gastric acid, intraluminal carcinogens, bacterial translocation and other noxious substances. Heat also affects other types of intercellular junctions, including Gap junctions and transporter proteins .…”

“…Environmental factors are most often discussed in the origin of ESCC, including the consumption of very hot beverages and food, a low intake of fresh fruit and vegetables, alcohol consumption, cigarette smoking and low socioeconomic status. Recently, two meta‐analyses showed that the consumption of hot beverages and food were significantly associated with ESCC …”

Investigating tea temperature and content as risk factors for esophageal cancer in an endemic region of Western Kenya: Validation of a questionnaire and analysis of polycyclic aromatic hydrocarbon content

“…However, De Jong and colleagues showed that drinking hot coffee (65°C) could increase intra-esophageal temperature by 6 – 12°C 27 , and an endoscopic survey in southern Brazil demonstrated that drinking very hot maté was associated with esophageal injury (esophagitis) 28 . Recent systematic reviews and meta-analyses have demonstrated an association between ingesting hot temperature food and beverages and ESCC 15,29,30 . A working group from the IARC has now classified very hot beverages as possibly carcinogenic 21,22 .…”

“…Consumption of hot food and beverages has been proposed as a risk factor for esophageal cancer in a number of different geographical locations 15 , including drinking hot maté in South America 16 ; drinking hot tea in Iran 17,18 ; and consumption of hot food and beverages in China 19,20 . Recently, the International Agency for Research on Cancer (IARC) defined drinking temperatures above 65°C as “very hot” and considered this exposure as probably carcinogenic (Group 2A) 21,22 .…”