Miles Fayth L, Chang Shen-Chih, Morgenstern Hal, Tashkin Donald, Rao Jian-Yu, Cozen Wendy, Mack Thomas, Lu Qing-Yi, Zhang Zuo-Feng
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA.
Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
Cancer Causes Control. 2016 Nov;27(11):1293-1300. doi: 10.1007/s10552-016-0792-8. Epub 2016 Aug 18.
The role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients.
The association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case-control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders.
A total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32-2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility.
These findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers.
添加糖的摄入在上呼吸道消化道(UADT)癌症中的作用尚不清楚。我们研究了含糖饮料与UADT癌症易感性以及UADT癌症患者总生存率之间的关联。
利用在洛杉矶县开展的一项基于人群的病例对照研究数据,评估了601例UADT癌症病例中膳食添加糖与UADT癌症易感性或总生存率之间的关联。采用无条件逻辑回归估计癌症易感性的比值比和95%置信区间(CI),采用Cox回归估计生存率的风险比(HR)及95%CI,并对相关混杂因素进行校正。
随访期间共观察到248例死亡(中位随访时间12.1年)。观察到饮料中的糖摄入量(包括软饮料和果汁)与UADT癌症病例较差的生存率呈正相关(调整后HR,四分位间距第4组与第1组相比:1.88;95%CI 1.29,2.72;趋势检验p = 0.002),含糖饮料的饮用量也与之相关(调整后HR,四分位间距第4组与第1组相比:95%CI 1.97,95%CI 1.32 - 2.93)。这主要归因于软饮料中的糖摄入。特别是,含糖饮料的高摄入量与食管癌病例较差的生存率相关,主要由鳞状细胞癌驱动。未观察到含糖饮料与癌症易感性之间的关联。
这些发现表明,饮用含糖饮料可能会降低与UADT癌症相关的生存率。应开展更多研究,以检验大量摄入添加糖或精制糖的癌症患者的生存率。此类研究可能会突出UADT癌症的预后因素。