Introduction: Previous observational studies have reported inconsistent findings on the association between consumption of sugar-sweetened soft drinks (SSSDs) and the risk of gastrointestinal (GI) cancer. This study investigated the associations between SSSD consumption and the risk of GI cancer using a systematic review and meta-analysis. Methods: Observational epidemiological studies were searched from the PubMed and EMBASE databases until June 2021. We conducted a meta-analysis of all included studies and subgroup meta-analyses based on various factors. Results: In a meta-analysis of 27 studies with nine case-control studies and 18 cohort studies, the consumption of SSSDs was modestly associated with an increased risk of GI cancer (odds ratio [OR]/relative risk [RR]: 1.08; 95% confidence interval [CI]: 1.01–1.16), with a significant positive dose-response relationship. In the subgroup meta-analysis by study design, there was a significant positive association between the consumption of SSSDs and GI cancer in cohort studies (RR: 1.11; 95% CI: 1.03–1.20; n = 18), but not in case-control studies. In the subgroup meta-analysis by type of cancer, consumption of SSSDs was significantly associated with an increased risk of colorectal cancer (OR/RR: 1.13; 95% CI: 1.07–1.19). Conclusions: This meta-analysis suggests that SSSD consumption significantly increases the risk of GI cancer, specifically colorectal cancer.

1.
Globocan
Global cancer observatory: cancer today
Lyon, France
IARC
2020
. Available from: https://gco.iarc.fr/today/fact-sheets-populations (Accessed on 20th April 2021).
2.
Sarfaraz
S
,
Bano
T
,
Fatima
W
,
Amjad
R
,
Mehak
A
,
Iqbal
M
.
Popularity of soft drinks: colored versus non-colored and risks associated with their prolonged usea
.
RADS J Pharm Pharm Sci
.
2020
;
5
:
13
9
.
3.
US Department of Agriculture
US Department of Health and Human Services
Dietary guidelines for Americans, 2015-2020
8th ed
Washington, DC
US Government Printing Office
2015
.
4.
White
JS
.
Sucrose, HFCS, and fructose: history, manufacture, composition, applications, and production
. In:
Fructose, high fructose corn syrup, sucrose and health
Humana Press
2014
. p.
13
33
.
5.
Goncalves
MD
,
Lu
C
,
Tutnauer
J
,
Hartman
TE
,
Hwang
SK
,
Murphy
CJ
.
High-fructose corn syrup enhances intestinal tumor growth in mice
.
Science
.
2019
;
363
(
6433
):
1345
9
.
6.
Augustin
LS
,
Kendall
CW
,
Jenkins
DJ
,
Willett
WC
,
Astrup
A
,
Barclay
AW
.
Glycemic index, glycemic load and glycemic response: an international scientific consensus summit from the international carbohydrate quality consortium (ICQC)
.
Nutr Metab Cardiovasc Dis
.
2015
;
25
(
9
):
795
815
.
7.
Wang
J
,
Lee
IM
,
Tworoger
SS
,
Buring
JE
,
Ridker
PM
,
Rosner
B
.
Plasma C-reactive protein and risk of breast cancer in two prospective studies and a meta-analysis
.
Cancer Epidemiol Biomarkers Prev
.
2015
;
24
(
8
):
1199
206
.
8.
Mueller
NT
,
Odegaard
A
,
Anderson
K
,
Yuan
JM
,
Gross
M
,
Koh
WP
.
Soft drink and juice consumption and risk of pancreatic cancer: the Singapore Chinese Health Study
.
Cancer Epidemiol Biomarkers Prev
.
2010
;
19
(
2
):
447
55
.
9.
Theodoratou
E
,
Farrington
SM
,
Tenesa
A
,
McNeill
G
,
Cetnarskyj
R
,
Korakakis
E
.
Associations between dietary and lifestyle risk factors and colorectal cancer in the Scottish population
.
Eur J Cancer Prev
.
2014
;
23
(
1
):
8
17
.
10.
Hodge
AM
,
Bassett
JK
,
Milne
RL
,
English
DR
,
Giles
GG
.
Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of obesity-related cancers
.
Public Health Nutr
.
2018
;
21
(
9
):
1618
26
.
11.
Mack
TM
,
Yu
MC
,
Hanisch
R
,
Henderson
BE
.
Pancreas cancer and smoking, beverage consumption, and past medical history
.
J Natl Cancer Inst
.
1986
;
76
(
1
):
49
60
.
12.
Lyon
JL
,
Mahoney
AW
,
French
TK
,
Moser
JR
.
Coffee consumption and the risk of cancer of the exocrine pancreas: a case-control study in a low-risk population
.
Epidemiology
.
1992
;
164
:
170
.
13.
Schernhammer
ES
,
Hu
FB
,
Giovannucci
E
,
Michaud
DS
,
Colditz
GA
,
Stampfer
MJ
.
Sugar-sweetened soft drink consumption and risk of pancreatic cancer in two prospective cohorts
.
Cancer Epidemiol Biomarkers Prev
.
2005
;
14
(
9
):
2098
105
.
14.
Nothlings
U
,
Murphy
SP
,
Wilkens
LR
,
Henderson
BE
,
Kolonel
LN
.
Dietary glycemic load, added sugars, and carbohydrates as risk factors for pancreatic cancer: the multiethnic cohort study
.
Am J Clin Nutr
.
2007
;
86
(
5
):
1495
501
.
15.
Bao
Y
,
Stolzenberg-Solomon
R
,
Jiao
L
,
Silverman
DT
,
Subar
AF
,
Park
Y
.
Added sugar and sugar-sweetened foods and beverages and the risk of pancreatic cancer in the National Institutes of Health–AARP Diet and Health Study
.
Am J Clin Nutr
.
2008
;
88
(
2
):
431
40
.
16.
Ibiebele
TI
,
Hughes
MC
,
O’Rourke
P
,
Webb
PM
,
Whiteman
DC
Australian Cancer Study
.
Cancers of the esophagus and carbonated beverage consumption: a population-based case-control study
.
Cancer Causes Control
.
2008
;
19
(
6
):
577
84
.
17.
Chan
JM
,
Wang
F
,
Holly
EA
.
Sweets, sweetened beverages, and risk of pancreatic cancer in a large population-based case-control study
.
Cancer Causes Control
.
2009
;
20
(
6
):
835
46
.
18.
Ren
JS
,
Freedman
ND
,
Kamangar
F
,
Dawsey
SM
,
Hollenbeck
AR
,
Schatzkin
A
.
Tea, coffee, carbonated soft drinks and upper gastrointestinal tract cancer risk in a large United States prospective cohort study
.
Eur J Cancer
.
2010
;
46
(
10
):
1873
81
.
19.
Zhang
X
,
Albanes
D
,
Beeson
WL
,
Van Den Brandt
PA
,
Buring
JE
,
Flood
A
.
Risk of colon cancer and coffee, tea, and sugar-sweetened soft drink intake: pooled analysis of prospective cohort studies
.
J Natl Cancer Inst
.
2010
;
102
(
11
):
771
83
.
20.
Genkinger
JM
,
Li
R
,
Spiegelman
D
,
Anderson
KE
,
Albanes
D
,
Bergkvist
L
.
Coffee, tea, and sugar-sweetened carbonated soft drink intake and pancreatic cancer risk: a pooled analysis of 14 cohort studies
.
Cancer Epidemiol Biomarkers Prev
.
2012
;
21
(
2
):
305
18
.
21.
Wang
Z
,
Uchida
K
,
Ohnaka
K
,
Morita
M
,
Toyomura
K
,
Kono
S
.
Sugars, sucrose and colorectal cancer risk: the Fukuoka colorectal cancer study
.
Scand J Gastroenterol
.
2014
;
49
(
5
):
581
8
.
22.
Navarrete-Munoz
EM
,
Wark
PA
,
Romaguera
D
,
Bhoo-Pathy
N
,
Michaud
D
,
Molina-Montes
E
.
Sweet-beverage consumption and risk of pancreatic cancer in the European prospective investigation into cancer and nutrition (EPIC)
.
Am J Clin Nutr
.
2016
;
104
(
3
):
760
8
.
23.
Makarem
N
,
Bandera
EV
,
Lin
Y
,
Jacques
PF
,
Hayes
RB
,
Parekh
N
.
Consumption of sugars, sugary foods, and sugary beverages in relation to adiposity-related cancer risk in the Framingham Offspring Cohort (1991–2013)
.
Cancer Prev Res
.
2018
;
11
(
6
):
347
58
.
24.
Chazelas
E
,
Srour
B
,
Desmetz
E
,
Kesse Guyot
E
,
Julia
C
,
Deschamps
V
.
Sugary drink consumption and risk of cancer: results from NutriNet-Sante prospective cohort
.
Br Med J
.
2019
366
l2408
.
25.
Malik
VS
,
Li
Y
,
Pan
A
,
De Koning
L
,
Schernhammer
E
,
Willett
WC
.
Long-term consumption of sugar-sweetened and artificially sweetened beverages and risk of mortality in US adults
.
Circulation
.
2019
;
139
(
18
):
2113
25
.
26.
Mullee
A
,
Romaguera
D
,
Pearson-Stuttard
J
,
Viallon
V
,
Stepien
M
,
Freisling
H
.
Association between soft drink consumption and mortality in 10 European countries
.
JAMA Intern Med
.
2019
;
179
(
11
):
1479
90
.
27.
Pacheco
LS
,
Anderson
CA
,
Lacey
JV
Jr
,
Giovannucci
EL
,
Lemus
H
,
Araneta
MR
.
Sugar-sweetened beverages and colorectal cancer risk in the California teachers study
.
PLoS One
.
2019
;
14
(
10
):
e0223638
.
28.
Wells
G
,
Shea
B
,
O’connell
D
,
Peterson
J
,
Welch
V
,
Losos
M
The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses
Ott. Hosp. Res. Inst
2014
. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
29.
Higgins
JP
,
Thompson
SG
.
Quantifying heterogeneity in a meta-analysis
.
Stat Med
.
2002
;
21
(
11
):
1539
58
.
30.
DerSimonian
R
,
Kacker
R
.
Random-effects model for meta-analysis of clinical trials: an update
.
Contemp Clin Trials
.
2007
;
28
(
2
):
105
14
.
31.
Macaskill
P
,
Walter
SD
,
Irwig
L
.
A comparison of methods to detect publication bias in meta-analysis
.
Stat Med
.
2001
;
20
(
4
):
641
54
.
32.
Moher
D
,
Liberati
A
,
Tetzlaff
J
,
Altman
DG
PRISMA Group
.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
.
PLoS Med
.
2009
;
6
(
7
):
e1000097
.
33.
Touvier
MK-GE
,
Kesse-Guyot
E
,
Méjean
C
,
Pollet
C
,
Malon
A
,
Castetbon
K
.
Comparison between an interactive web-based self administered 24 h dietary record and an interview by a dietitian for large-scale epidemiological studies
.
Br J Nutr
.
2011
;
105
(
7
):
1055
64
.
34.
DiMeglio
DP
,
Mattes
RD
.
Liquid versus solid carbohydrate: effects on food intake and body weight
.
Int J Obes Relat Metab Disord
.
2000
;
24
(
6
):
794
800
.
35.
World Cancer Research Fund International
Diet, nutrition, physical activity and cancer: a global perspective: a summary of the third expert report
World Cancer Research Fund International
2018
. Available from: https://www.wcrf.org/sites/default/files/Summary-third-expert-report.pdf (Accessed on 12th May 2021).
36.
Ma
J
,
McKeown
NM
,
Hwang
SJ
,
Hoffmann
U
,
Jacques
PF
,
Fox
CS
.
Sugar-sweetened beverage consumption is associated with change of visceral adipose tissue over 6 years of follow-up
.
Circulation
.
2016
;
133
(
4
):
370
7
.
37.
Maersk
M
,
Belza
A
,
Stodkilde-Jorgensen
H
,
Ringgaard
S
,
Chabanova
E
,
Thomsen
H
.
Sucrose sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study
.
Am J Clin Nutr
.
2012
;
95
(
2
):
283
9
.
38.
Stanhope
KL
,
Schwarz
JM
,
Keim
NL
,
Griffen
SC
,
Bremer
AA
,
Graham
JL
.
Consuming fructose sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans
.
J Clin Invest
.
2009
;
119
(
5
):
1322
34
.
39.
Doyle
SL
,
Donohoe
CL
,
Lysaght
J
,
Reynolds
JV
.
Visceral obesity, metabolic syndrome, insulin resistance and cancer
.
Proc Nutr Soc
.
2012
;
71
(
1
):
181
9
.
40.
Liu
S
,
Manson
JE
,
Buring
JE
,
Stampfer
MJ
,
Willett
WC
,
Ridker
PM
.
Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle aged women
.
Am J Clin Nutr
.
2002
;
75
(
3
):
492
8
.
41.
Rajendran
P
,
Rengarajan
T
,
Thangavel
J
,
Nishigaki
Y
,
Sakthisekaran
D
,
Sethi
G
.
The vascular endothelium and human diseases
.
Int J Biol Sc
.
2013
;
9
(
10
):
1057
69
.
42.
Uribarri
J
,
Stirban
A
,
Sander
D
,
Cai
W
,
Negrean
M
,
Buenting
CE
.
Single oral challenge by advanced glycation end products acutely impairs endothelial function in diabetic and nondiabetic subjects
.
Diabetes Care
.
2007
;
30
(
10
):
2579
82
.
43.
Turati
F
,
Galeone
C
,
Gandini
S
,
Augustin
LS
,
Jenkins
DJA
,
Pelucchi
C
.
High glycemic index and glycemic load are associated with moderately increased cancer risk
.
Mol Nutr Food Res
.
2015
;
59
(
7
):
1384
94
.
44.
Tzatzarakis
MN
,
Vakonaki
E
,
Moti
S
,
Alegakis
A
,
Tsitsimpikou
C
,
Tsakiris
I
.
Quantification of 4-Methylimidazole in soft drinks, sauces and vinegars of Greek market using two liquid chromatography techniques
.
Food Chem Toxicol
.
2017
107
Pt B
565
71
.
45.
Morita
T
,
Uneyama
C
.
Genotoxicity assessment of 4-methylimidazole: regulatory perspectives
.
Genes Environ
.
2016
;
38
:
20
.
46.
International Agency for Research on Cancer
.
4-Methylimidazole
. In
IARC monographs on the evaluation of carcinogenic risks to humans volume 101: some chemicals present in industrial and consumer products, food and drinking-water
.
2013
. Available from: https://monographs.iarc.fr/ENG/Monographs/vol101/mono101-015.pdf.
47.
Boyle
P
,
Koechlin
A
,
Autier
P
.
Sweetened carbonated beverage consumption and cancer risk: meta-analysis and review
.
Eur J Cancer Prev
.
2014
;
23
(
5
):
481
90
.
48.
Milajerdi
A
,
Larijani
B
,
Esmaillzadeh
A
.
Sweetened beverages consumption and pancreatic cancer: a meta-analysis
.
Nutr Cancer
.
2019
;
71
(
3
):
375
84
.
You do not currently have access to this content.