We can't exclude residual confounding. Maybe people drink tea differently in different social situations. Maybe hot tea is more often served with alcohol. Maybe a single measure of how hot people drink their tea isn't that great a predictor 10 years later when they get cancer
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To be precisely accurate, I would say that, based on the literature to date, there is likely an association between very hot beverages and esophageal squamous cell carcinoma, however the causality in this relationship has not been fully elucidated and confounding factors exist
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While it is possible that very hot drinks cause cancer, it is currently not unlikely that a third factor, perhaps pollution-induced esophageal damage, is confounding the relationship
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