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Cited by 111Diet, Metabolism, and DiseasePancreatic and Hepatic Oncology ResearchNutritional Studies and Diet

Dietary fructose, carbohydrates, glycemic indices and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies

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Aune, D., Chan, D.S.M., Vieira, A.R., Navarro Rosenblatt, D.A., Vieira, R., Greenwood, D.C., Cade, J.E., Burley, V.J. +1 more·2012·Annals of Oncology
DOI 10.1093/annonc/mds076
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Abstract

Background Dietary carbohydrates, glycemic load and glycemic index have been hypothesized to influence pancreatic cancer risk, but epidemiological studies have been inconsistent. We conducted a systematic review and meta-analysis of prospective studies to clarify these results.Methods PubMed and several other databases were searched for prospective studies of intake of carbohydrates, glycemic index and glycemic load and pancreatic cancer up to September 2011. Summary relative risks were estimated using a random effects model.Results Ten cohort studies (13 publications) were included in the meta-analysis. The summary relative risk (RR) per 10 glycemic index units was 1.02 [95% confidence interval (CI): 0.93-1.12, I(2) = 0%], per 50 glycemic load units was 1.03 (95% CI: 0.93-1.14, I(2) = 10%), per 100 g/day of total carbohydrates was 0.97 (95% CI: 0.81-1.16, I(2) = 35%), and per 25 g/day of sucrose intake was 1.05 (95% CI: 0.85-1.23, I(2) = 53%). A positive association was observed with fructose intake, summary RR = 1.22 (95% CI: 1.08-1.37, I(2) = 0%) per 25 g/day.Conclusions This meta-analysis does not support an association between diets high in glycemic index, glycemic load, total carbohydrates or sucrose and pancreatic cancer risk. The finding of an increased risk with fructose intake warrants further investigation in studies with better adjustment for confounding and in non-American populations.

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  • The association between fructose intake and incidence of pancreatic cancer remained significant in subgroups of studies that adjusted for smoking, body mass index, red and processed meat consumption, and energy intake.

    “The association between fructose intake and incidence of pancreatic cancer remained significant in the subgroups of studies that adjusted for smoking, body mass index, red and processed meat consumption, and energy intake, whereas the association was diminished in the subgroups of studies that adjusted for alcohol consumption, diabetes status, or physical activity (fig 2; fig 5).72”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [72]

  • 25 g/day of fructose intake is linearly associated with a 22% higher risk of pancreatic cancer (risk ratio 1.22, 1.08 to 1.37), graded low quality evidence.

    “a meta-analysis conducted by Aune and colleagues found that 25 g/day of fructose intake was linearly associated with a 22% higher risk of pancreatic cancer (risk ratio 1.22, 1.08 to 1.37) (low; III).72”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [72]

  • The association between fructose intake and incidence of pancreatic cancer was diminished in subgroups of studies that adjusted for alcohol consumption, diabetes status, or physical activity.

    “The association between fructose intake and incidence of pancreatic cancer remained significant in the subgroups of studies that adjusted for smoking, body mass index, red and processed meat consumption, and energy intake, whereas the association was diminished in the subgroups of studies that adjusted for alcohol consumption, diabetes status, or physical activity (fig 2; fig 5).72”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [72]

  • No significant association was observed between sucrose intake and pancreatic cancer.

    “We observed no significant association between sucrose intake and pancreatic cancer.72”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [72]

  • Significant harmful associations between dietary sugar consumption and a higher risk of cancer were observed for breast cancer, breast cancer mortality, hepatocellular carcinoma, prostate cancer, pancreatic cancer, overall cancer risk, and overall cancer mortality.

    “Significant harmful associations between dietary sugar consumption and a higher risk of cancer were observed for breast cancer,19 breast cancer mortality,18 hepatocellular carcinoma,18 prostate cancer,18 pancreatic cancer,72 overall cancer risk,18 and overall cancer mortality.18”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [72]

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Authors
Aune, D., Chan, D. S. M., Vieira, A. R., Navarro Rosenblatt, D. A., Vieira, R., Greenwood, D. C., Cade, J. E., Burley, V. J., & Norat, T.
Affiliations
  • Imperial College London (GB)
  • University of Leeds (GB)
ORCID
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2012-10
Volume
23
Issue
10
Pages
2536-2546
ISSN
0923-7534 (ISSN-L)
DOI
10.1093/annonc/mds076
OpenAlex
W2145809841
Cited by
111
References
59
Citations by year
2026: 4 · 2025: 7 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 12 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 10 · 2015: 8 · 2014: 6 · 2013: 6
FWCI
0.89
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
World Cancer Research Fund (2007/SP01)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
pancreatic cancer, dietary fructose, dietary carbohydrates, glycemic index, glycemic load, sucrose intake, cancer risk, diet and cancer
MeSH terms
Adult, Aged, Carbohydrates, Female, Fructose, Humans, Male, Middle Aged, Pancreatic Neoplasms, Cohort Studies, Glycemic Index

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