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Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women
Open accessAbstract
Objective: Sugar-sweetened beverage (SSB) consumption had substantially increased across successive US birth cohorts until 2000, and adolescents and young adults under age 50 years have the highest consumption. However, the link between SSBs and early-onset colorectal cancer (EO-CRC) remains unexamined. Design: In the Nurses’ Health Study II (1991–2015), we prospectively investigated the association of SSB intake in adulthood and adolescence with EO-CRC risk among 95 464 women who had reported adulthood beverage intake using validated food frequency questionnaires (FFQs) every 4 years. A subset of 41 272 participants reported beverage intake at age 13–18 years using a validated high school-FFQ in 1998. Cox proportional hazards models were used to estimate relative risks (RRs) with 95% CIs. Results: We documented 109 EO-CRC cases. Compared with individuals who consumed <1 serving/week of SSBs in adulthood, women who consumed ≥2 servings/day had a more than doubled risk of EO-CRC (RR 2.18; 95% CI 1.10 to 4.35; p trend =0.02), with a 16% higher risk (RR 1.16; 95% CI 1.00 to 1.36) per serving/day increase. Each serving/day increment of SSB intake at age 13–18 years was associated with a 32% higher risk of EO-CRC (RR 1.32; 95% CI 1.00 to 1.75). Replacing each serving/day of adulthood SSB intake with that of artificially sweetened beverages, coffee, reduced fat milk or total milk was associated with a 17%–36% lower risk of EO-CRC. Conclusion: Higher SSB intake in adulthood and adolescence was associated with a higher risk of EO-CRC among women. Reduction of SSB consumption among adolescents and young adults may serve as a potential strategy to alleviate the growing burden of EO-CRC.
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“excessive fructose consumption might lead to intestinal flora disturbance and intestinal barrier deterioration, which promote the development of metabolic endotoxaemia, inflammation, and lipid accumulation, finally leading to colorectal carcinogenesis.20 122 123”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [20]
Experimental — accuracy not yet measuredIn the citing paper
“Compared with women who consumed less than one serving a week of sugar sweetened beverages in adulthood, those who consumed two or more servings a day had a 118% higher risk of early onset colorectal cancer (risk ratio 2.18, 1.10 to 4.35).”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [20]
In the citing paper
“Notably, the non-significant association between sugar sweetened beverage consumption and the risk of colorectal cancer observed both in this study and in our umbrella review was inconsistent with another cohort conducted in women.20”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [20]
In the citing paper
“Each one serving a day increment of sugar sweetened beverage consumption was associated with a 16% (risk ratio 1.16, 1.00 to 1.36) increased risk of early onset colorectal cancer.20”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [20]
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Citations
Cites
Colorectal cancer statistics, 2020
Siegel, R. L., Miller, K. D., Sauer, A. G., Fedewa, S. A., Butterly, L. F., Anderson, J. C., Cercek, A., Smith, R. A., & Jemal, A. (2020) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21601 · Cited by 5,080
Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012
Menke, A., Casagrande, S., Geiss, L., & Cowie, C. C. (2015) · JAMA · doi:10.1001/jama.2015.10029 · Cited by 2,362
International Tables of Glycemic Index and Glycemic Load Values: 2008
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Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease
Chiuve, S. E., Fung, T. T., Rimm, E. B., Hu, F. B., McCullough, M. L., Wang, M., Stampfer, M. J., & Willett, W. C. (2012) · The Journal of Nutrition · doi:10.3945/jn.111.157222 · Cited by 1,951
Self-citationLudwig (2002) · doi:10.1001/jama.287.18.2414 · Cited by 1,775
Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.058362 · Cited by 1,668
Self-citationSugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk
Malik, V. S., Popkin, B. M., Bray, G. A., Després, J.-P., & Hu, F. B. (2010) · Circulation · doi:10.1161/circulationaha.109.876185 · Cited by 1,641
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Self-citationColorectal Cancer Incidence Patterns in the United States, 1974–2013
Siegel, R. L., Fedewa, S. A., Anderson, W. F., Miller, K. D., Ma, J., Rosenberg, P. S., & Jemal, A. (2017) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/djw322 · Cited by 1,002
Global patterns and trends in colorectal cancer incidence in young adults
Siegel, R. L., Torre, L. A., Soerjomataram, I., Hayes, R. B., Bray, F., Weber, T. K., & Jemal, A. (2019) · Gut · doi:10.1136/gutjnl-2019-319511 · Cited by 979
Cited by
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Colorectal cancer statistics, 2023
Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A., & Jemal, A. (2023) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21772 · Cited by 4,068
Patel, S. G., Karlitz, J. J., Yen, T., Lieu, C. H., & Boland, C. R. (2022) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(21)00426-x · Cited by 812
Is early-onset cancer an emerging global epidemic? Current evidence and future implications
Ugai, T., Sasamoto, N., Lee, H., Ando, M., Song, M., Tamimi, R. M., Kawachi, I. I., Campbell, P. T., Giovannucci, E. L., Weiderpass, E., et al. (2022) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-022-00672-8 · Cited by 652
Self-citationIncreasing Incidence of Early-Onset Colorectal Cancer
Sinicrope, F. A. (2022) · New England Journal of Medicine · doi:10.1056/nejmra2200869 · Cited by 550
Eng, C., Yoshino, T., Ruíz‐García, E., Mostafa, N., Cann, C., O’Brian, B., Benny, A., Perez, R. O., & Cremolini, C. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00360-x · Cited by 508
Metadata
- Authors
- Hur, J., Otegbeye, E., Joh, H.-K., Nimptsch, K., Ng, K., Ogino, S., Meyerhardt, J. A., Chan, A. T., Willett, W. C., Wu, K., Giovannucci, E., & Cao, Y.
- Affiliations
- Harvard University (US)
- Washington University in St. Louis (US)
- Broad Institute (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Cao, Yin
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2021-05-06
- Volume
- 70
- Issue
- 12
- Pages
- 2330-2336
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC8571123
- OpenAlex
- W3159187004
- Cited by
- 229
- References
- 59
- Citations by year
- 2026: 34 · 2025: 50 · 2024: 36 · 2023: 57 · 2022: 44 · 2021: 8
- FWCI
- 31.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion)
- Funders
- National Institutes of Health (K07 CA218377, R01 CA151993, R01 CA205406, R03 CA197879, R21 CA222940, R21 CA230873, R35 CA197735, R35 CA253185, R37 CA246175, T32 CA009621, U01 CA176726)
- U.S. Department of Defense (CA160344)
- Massachusetts General Hospital (Stuart and Suzanne Steele MGH Research Scholar)
- American Institute for Cancer Research (Investigator Initiated Grant)
- Project P Fund (N/A)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- sugar-sweetened beverages, early-onset colorectal cancer, women, artificially sweetened beverages, coffee, milk consumption, dietary risk factors, Nurses' Health Study II
- MeSH terms
- Sugar-Sweetened Beverages, Adolescent, Adult, Female, Humans, Prospective Studies, Surveys and Questionnaires, United States, Colorectal Neoplasms
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