Intake of sugar-sweetened beverages linked to early-onset colorectal cancer
“Early-onset colorectal cancer (EO-CRC, age <50 years at diagnosis) is rapidly rising in the U.S., with an unclear understanding of its etiology and contributors to the rise. Sugar-sweetened beverages (SSBs) exert adverse metabolic repercussions throughout the life course, including insulin resistance and inflammation. Higher SSB intake was also associated with obesity, which has been previously linked to risk of EO-CRC,” Yin Cao, MPH, ScD, division of public health sciences, department of surgery, Washington University School of Medicine, told Healio. “Thus, we expect SSB may be an emerging risk factor for EO-CRC and likely contribute to the rising incidence of EO-CRC.”
In a prospective cohort study, researchers analyzed 95,464 women from the Nurses’ Health Study to investigate the association between SSB intake and EO-CRC risk. Participants reported adulthood beverage intake via validated food frequency questionnaire every 4-years from 1991 to 2015; researchers estimated relative risks using Cox proportional hazards models.
According to study results, there were 109 incident EO-CRC cases over up to 24-years of follow-up. Compared with women who consumed less than one serving per week of SSBs in adulthood, women who consumed more than two servings per day of SSBs had a 2.2-fold higher risk for EO-CRC (RR = 2.18; 95% CI, 1.1-4.35) with a 16% higher risk for each additional serving per day (RR = 1.16; 95% CI, 1-1.36).
In a subset of 41,272 women who reported beverage intake at age 13 years to age 18 years, each serving per day increment of SSB intake correlated with a 32% higher risk for EO-CRC (RR = 1.32; 95% CI, 1-1.75). Researchers noted replacement of one SSB serving per day with an equivalent amount of artificially sweetened beverage, coffee, reduced fat milk or total milk correlated with a 17% to 36% decreased risk for EO-CRC (RR = 0.83; 95% CI, 0.69-0.99; RR = 0.82; 95% CI, 0.68-0.99; RR = 0.65; 95% CI, 0.47-0.90 and RR = 0.64; 95% CI, 0.46-0.89, respectively).
“On top of the well-known adverse metabolic and health consequences of SSBs, our findings have added another reason to avoid SSBs since earlier life stages provided preliminary support that SSB intake may contribute to the rising incidence CRC under age 50. In addition, our findings also suggest that reducing SSB intake and/or replacing SSBs with other healthier beverages, in particular milk, would be a better choice for long-term health,” Cao said. “We hope our work helps raise the awareness of the rising incidence of EO-CRC among healthcare providers and the general public and advance the current and future understanding of the etiology of EO-CRC.”