February 6, 2018 -- Tea lovers who take their daily cup scalding hot are raising their chance of having esophageal cancer if they also drink alcohol every day or if they smoke, say researchers.

A study that followed more than 450,000 people in China for 9 years provides evidence of a relationship between drinking hot tea every day, regular drinking and smoking, and a higher risk of esophageal cancer.

The study, led by Canqing Yu, PhD, of Peking University Health Science Center in Beijing, China, was published online February 5 in the Annals of Internal Medicine.

The risk of esophageal cancer was 5 times higher in people who drank very hot tea and also drank more than 15 grams of alcohol -- a standard alcoholic drink -- every day, compared with those who drank tea less than once a week and had fewer than 15 grams of alcohol daily.

The risk for esophageal cancer was doubled in those who drank piping hot tea each day and smoked tobacco, compared with nonsmokers who drank tea only occasionally.

"Our findings show a noticeable increase in esophageal cancer risk associated with a combination of high-temperature tea drinking, excessive alcohol consumption, and tobacco smoking," Yu and colleagues write. "They suggest that abstaining from hot tea might be beneficial for preventing esophageal cancer in persons who drink alcohol excessively or smoke."

The rate of esophageal cancer is rising globally, particularly in men in less developed countries, the study says. In China, where the rate of esophageal cancer is among the highest in the world, men who drink tea often smoke and drink alcohol.

The analysis included 456,155 participants aged 30 to 79 years who did not have a history of cancer. All were enrolled between 2004 and 2008 from five urban and five rural regions of China. At the start of the study, participants reported the temperature at which they drank tea as well as some of their other behaviors, including drinking alcohol and smoking.

After 9 years, researchers found 1731 cases of esophageal cancer reported in 1,106 men and 625 women.