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BACKGROUND: Consumption of very-hot beverages/food is a probable carcinogen. In East Africa, we investigated esophageal
squamous cell carcinoma (ESCC) risk in relation to four thermal exposure metrics separately and in a combined score.
METHODS: From the ESCCAPE case–control studies in Blantyre, Malawi (2017-20) and Kilimanjaro, Tanzania (2015-19), we used
logistic regression models adjusted for country, age, sex, alcohol and tobacco, to estimate odds ratios (ORs) and 95% confidence
intervals (CIs) for self-reported thermal exposures whilst consuming tea, coffee and/or porridge.
RESULTS: The study included 849 cases and 906 controls. All metrics were positively associated with ESCC: temperature of drink/
food (OR 1.92 (95% CI: 1.50, 2.46) for ‘very hot’ vs ‘hot’), waiting time before drinking/eating (1.76 (1.37, 2.26) for <2 vs 2–5 minutes),
consumption speed (2.23 (1.78, 2.79) for ‘normal’ vs ‘slow’) and mouth burning (1.90 (1.19, 3.01) for ≥6 burns per month vs none).
Amongst consumers, the composite score ranged from 1 to 12, and ESCC risk increased with higher scores, reaching an OR of 4.6
(2.1, 10.0) for scores of ≥9 vs 3.
CONCLUSIONS: Thermal exposure metrics were strongly associated with ESCC risk. Avoidance of very-hot food/beverage
consumption may contribute to the prevention of ESCC in East Africa |
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