The association between coffee consumption and esophageal cancer risk: a systematic review and meta-analysis of current observational evidence
Background Esophageal cancer remains a leading cause of cancer-related mortality worldwide, yet the association between coffee consumption—a ubiquitous dietary exposure—and its risk remains inconclusive. This meta-analysis systematically evaluates the association between coffee consumption and esophageal cancer risk, aiming to quantify the overall effect and explore potential heterogeneity. Methods A systematic search of PubMed, Cochrane Library, Embase, and Web of Science was conducted up to January 2026 for studies comparing coffee intake between esophageal cancer patients and healthy controls. Two reviewers independently extracted data. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Heterogeneity was assessed using the I2 statistic. Certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Across 22 included studies encompassing 1,775,988 participants (7,124 cases), neither cohort nor case-control studies demonstrated a significant association between coffee consumption and esophageal cancer risk. The pooled HR from cohort studies was 0.87 (95% CI: 0.74–1.03; I2=24.2%), while the pooled OR from case-control studies was 1.02 (95% CI: 0.77–1.35; I2=66.7%). Conclusions This meta-analysis found no statistically significant association between coffee consumption and esophageal cancer risk. The available evidence, of low certainty, does not support coffee as a major risk factor. Exploratory analyses on beverage temperature are inconclusive and require confirmation in prospective studies with standardized exposure assessment. This review was registered in PROSPERO (CRD42024562527).