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Sugar-sweetened beverage and sugar consumption and colorectal cancer incidence and mortality according to anatomic subsite

Yuan, Chen ; Joh, Hee-Kyung ; Wang, Qiao-Li LU orcid ; Zhang, Yin ; Smith-Warner, Stephanie A ; Wang, Molin ; Song, Mingyang ; Cao, Yin ; Zhang, Xuehong and Zoltick, Emilie S , et al. (2022) In The American journal of clinical nutrition 115(6). p.1481-1489
Abstract

BACKGROUND: Recent preclinical research strongly suggests that dietary sugars can enhance colorectal tumorigenesis by direct action, particularly in the proximal colon that unabsorbed fructose reaches.

OBJECTIVES: We aimed to examine long-term consumption of sugar-sweetened beverages (SSBs) and total fructose in relation to incidence and mortality of colorectal cancer (CRC) by anatomic subsite.

METHODS: We followed 121,111 participants from 2 prospective US cohort studies, the Nurses' Health Study (1984-2014) and Health Professionals Follow-Up Study (1986-2014), for incident CRC and related death. Cox proportional hazards regression was used to compute HRs and 95% CIs.

RESULTS: During follow-up, we documented 2733... (More)

BACKGROUND: Recent preclinical research strongly suggests that dietary sugars can enhance colorectal tumorigenesis by direct action, particularly in the proximal colon that unabsorbed fructose reaches.

OBJECTIVES: We aimed to examine long-term consumption of sugar-sweetened beverages (SSBs) and total fructose in relation to incidence and mortality of colorectal cancer (CRC) by anatomic subsite.

METHODS: We followed 121,111 participants from 2 prospective US cohort studies, the Nurses' Health Study (1984-2014) and Health Professionals Follow-Up Study (1986-2014), for incident CRC and related death. Cox proportional hazards regression was used to compute HRs and 95% CIs.

RESULTS: During follow-up, we documented 2733 incident cases of CRC with a known anatomic location, of whom 901 died from CRC. Positive associations of SSB and total fructose intakes with cancer incidence and mortality were observed in the proximal colon but not in the distal colon or rectum (Pheterogeneity ≤ 0.03). SSB consumption was associated with a statistically significant increase in the incidence of proximal colon cancer (HR per 1-serving/d increment: 1.18; 95% CI: 1.03, 1.34; Ptrend = 0.02) and a more pronounced elevation in the mortality of proximal colon cancer (HR: 1.39; 95% CI: 1.13, 1.72; Ptrend = 0.002). Similarly, total fructose intake was associated with increased incidence and mortality of proximal colon cancer (HRs per 25-g/d increment: 1.18; 95% CI: 1.03, 1.35; and 1.42; 95% CI: 1.12, 1.79, respectively). Moreover, SSB and total fructose intakes during the most recent 10 y, rather than those from a more distant period, were associated with increased incidence of proximal colon cancer.

CONCLUSIONS: SSB and total fructose consumption were associated with increased incidence and mortality of proximal colon cancer, particularly during later stages of tumorigenesis.

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publishing date
type
Contribution to journal
publication status
published
keywords
Beverages/analysis, Carcinogenesis, Colonic Neoplasms/epidemiology, Colorectal Neoplasms/epidemiology, Dietary Sugars, Follow-Up Studies, Fructose/adverse effects, Humans, Incidence, Prospective Studies, Sugar-Sweetened Beverages/adverse effects, Sugars
in
The American journal of clinical nutrition
volume
115
issue
6
pages
1481 - 1489
publisher
Elsevier
external identifiers
  • pmid:35470384
  • scopus:85131700965
ISSN
1938-3207
DOI
10.1093/ajcn/nqac040
language
English
LU publication?
no
additional info
© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.
id
8f416e73-3acc-437c-91e1-784fb0e0555e
date added to LUP
2025-05-12 17:03:45
date last changed
2025-06-10 06:56:40
@article{8f416e73-3acc-437c-91e1-784fb0e0555e,
  abstract     = {{<p>BACKGROUND: Recent preclinical research strongly suggests that dietary sugars can enhance colorectal tumorigenesis by direct action, particularly in the proximal colon that unabsorbed fructose reaches.</p><p>OBJECTIVES: We aimed to examine long-term consumption of sugar-sweetened beverages (SSBs) and total fructose in relation to incidence and mortality of colorectal cancer (CRC) by anatomic subsite.</p><p>METHODS: We followed 121,111 participants from 2 prospective US cohort studies, the Nurses' Health Study (1984-2014) and Health Professionals Follow-Up Study (1986-2014), for incident CRC and related death. Cox proportional hazards regression was used to compute HRs and 95% CIs.</p><p>RESULTS: During follow-up, we documented 2733 incident cases of CRC with a known anatomic location, of whom 901 died from CRC. Positive associations of SSB and total fructose intakes with cancer incidence and mortality were observed in the proximal colon but not in the distal colon or rectum (Pheterogeneity ≤ 0.03). SSB consumption was associated with a statistically significant increase in the incidence of proximal colon cancer (HR per 1-serving/d increment: 1.18; 95% CI: 1.03, 1.34; Ptrend = 0.02) and a more pronounced elevation in the mortality of proximal colon cancer (HR: 1.39; 95% CI: 1.13, 1.72; Ptrend = 0.002). Similarly, total fructose intake was associated with increased incidence and mortality of proximal colon cancer (HRs per 25-g/d increment: 1.18; 95% CI: 1.03, 1.35; and 1.42; 95% CI: 1.12, 1.79, respectively). Moreover, SSB and total fructose intakes during the most recent 10 y, rather than those from a more distant period, were associated with increased incidence of proximal colon cancer.</p><p>CONCLUSIONS: SSB and total fructose consumption were associated with increased incidence and mortality of proximal colon cancer, particularly during later stages of tumorigenesis.</p>}},
  author       = {{Yuan, Chen and Joh, Hee-Kyung and Wang, Qiao-Li and Zhang, Yin and Smith-Warner, Stephanie A and Wang, Molin and Song, Mingyang and Cao, Yin and Zhang, Xuehong and Zoltick, Emilie S and Hur, Jinhee and Chan, Andrew T and Meyerhardt, Jeffrey A and Ogino, Shuji and Ng, Kimmie and Giovannucci, Edward L and Wu, Kana}},
  issn         = {{1938-3207}},
  keywords     = {{Beverages/analysis; Carcinogenesis; Colonic Neoplasms/epidemiology; Colorectal Neoplasms/epidemiology; Dietary Sugars; Follow-Up Studies; Fructose/adverse effects; Humans; Incidence; Prospective Studies; Sugar-Sweetened Beverages/adverse effects; Sugars}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{1481--1489}},
  publisher    = {{Elsevier}},
  series       = {{The American journal of clinical nutrition}},
  title        = {{Sugar-sweetened beverage and sugar consumption and colorectal cancer incidence and mortality according to anatomic subsite}},
  url          = {{http://dx.doi.org/10.1093/ajcn/nqac040}},
  doi          = {{10.1093/ajcn/nqac040}},
  volume       = {{115}},
  year         = {{2022}},
}