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Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort

Stepien, Magdalena ; Duarte-Salles, Talita ; Fedirko, Veronika ; Trichopoulou, Antonia ; Lagiou, Pagona ; Bamia, Christina ; Overvad, Kim ; Tjønneland, Anne ; Hansen, Louise and Boutron-Ruault, Marie Christine , et al. (2016) In European Journal of Nutrition 55(1). p.7-20
Abstract

Purpose: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. Methods: After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical... (More)

Purpose: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. Methods: After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status). Results: No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of >6 servings/week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11–3.02, ptrend = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03–1.09, ncases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; ncases = 127, pheterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (<1 serving/week: HR 0.60; 95 % CI 0.38–0.95; ptrend = 0.02 vs. non-consumers). Conclusions: Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biliary tract cancers, Fruit and vegetable juice, Hepatocellular carcinoma, Prospective cohort, Soft drink
in
European Journal of Nutrition
volume
55
issue
1
pages
14 pages
publisher
Springer
external identifiers
  • scopus:84957433881
  • pmid:25528243
ISSN
1436-6207
DOI
10.1007/s00394-014-0818-5
language
English
LU publication?
yes
id
583df69e-9f9e-49fb-8351-3d936f8ea482
date added to LUP
2024-05-02 16:47:23
date last changed
2024-05-16 18:39:10
@article{583df69e-9f9e-49fb-8351-3d936f8ea482,
  abstract     = {{<p>Purpose: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. Methods: After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status). Results: No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of &gt;6 servings/week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11–3.02, p<sub>trend</sub> = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03–1.09, n<sub>cases</sub> = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95–1.06; n<sub>cases</sub> = 127, p<sub>heterogeneity</sub> = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (&lt;1 serving/week: HR 0.60; 95 % CI 0.38–0.95; p<sub>trend</sub> = 0.02 vs. non-consumers). Conclusions: Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.</p>}},
  author       = {{Stepien, Magdalena and Duarte-Salles, Talita and Fedirko, Veronika and Trichopoulou, Antonia and Lagiou, Pagona and Bamia, Christina and Overvad, Kim and Tjønneland, Anne and Hansen, Louise and Boutron-Ruault, Marie Christine and Fagherazzi, Guy and Severi, Gianluca and Kühn, Tilman and Kaaks, Rudolf and Aleksandrova, Krasimira and Boeing, Heiner and Klinaki, Eleni and Palli, Domenico and Grioni, Sara and Panico, Salvatore and Tumino, Rosario and Naccarati, Alessio and Bueno-de-Mesquita, H. Bas and Peeters, Petra H. and Skeie, Guri and Weiderpass, Elisabete and Parr, Christine L. and Quirós, José Ramón and Buckland, Genevieve and Molina-Montes, Esther and Amiano, Pilar and Chirlaque, Maria Dolores and Ardanaz, Eva and Sonestedt, Emily and Ericson, Ulrika and Wennberg, Maria and Nilsson, Lena Maria and Khaw, Kay Tee and Wareham, Nick and Bradbury, Kathryn E. and Ward, Heather A. and Romieu, Isabelle and Jenab, Mazda}},
  issn         = {{1436-6207}},
  keywords     = {{Biliary tract cancers; Fruit and vegetable juice; Hepatocellular carcinoma; Prospective cohort; Soft drink}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{1}},
  pages        = {{7--20}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort}},
  url          = {{http://dx.doi.org/10.1007/s00394-014-0818-5}},
  doi          = {{10.1007/s00394-014-0818-5}},
  volume       = {{55}},
  year         = {{2016}},
}