Feng Linya, Gao Juan, Xia Weihang, Li Yaru, Lowe Scott, Yau Vicky, Ma Shaodi, Zhou Zhen, Ding Ping'an, Cheng Ce, Bentley Rachel, Wang Yichen, Zhou Qin, Wang Kai, Wu Birong, Xie Peng, Liu Haixia, Sun Chenyu
Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China.
Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA.
Eur J Clin Nutr. 2023 Oct;77(10):941-952. doi: 10.1038/s41430-023-01302-x. Epub 2023 Jul 12.
The association between sugar-sweetened beverages intake and colorectal cancer (CRC) remains controversial. A metaanalysis was performed to clarify the correlation between sugar-sweetened beverages and CRC risk/mortality. A systematic literature search was conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP database. Articles were restricted to be available in any language until March 31, 2022. The highest exposed categories were used to calculate the pooled relative risks (RR) values. Pooled relative risks (RR) and 95% confidence intervals (CI) were used to estimate the association of sugar-sweetened beverages with CRC risk and mortality. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. A total of 17 studies (6 case-control and 11 cohort) involving 557,391 subjects were included in this meta-analysis. The pooled RRs for CRC incidence and mortality among people taking sugar-sweetened beverages were 1.17 (95% CI: 1.07-1.28) and 1.13 (95% CI: 0.99-1.29), respectively. In subgroup analysis, a correlation was found in the distal colon with a pooled RR of 1.41 (95% CI: 1.10-1.80). There was no correlation in the proximal colon with a pooled RR of 1.58 (95% CI: 0.79-3.17). We found statistically significant associations between CRC incidence and sugar-sweetened beverages intake in North America and Oceania, with pooled RRs of 1.16 (95% CI: 1.00-1.33) and 1.32 (95% CI: 1.13-1.55), respectively. In sensitivity analysis, after excluding each study and calculating heterogeneity and effect sizes, there was still a correlation between sugar-sweetened beverages intake and CRC risk. This meta-analysis suggests that sugar-sweetened beverages intake may increase CRC risk, independent of CRC mortality. Whether CRC risk increases with increased sugar-sweetened beverage intake needs further investigation in the future. This meta-analysis aimed to indicate the relationship between sugar-sweetened beverages intake and the risk and mortality of colorectal cancer. A total of 17 studies involving 557,391 subjects were included. The results showed that sugar-sweetened beverages may increase the risk of colorectal cancer but may not be associated with colorectal cancer mortality.
含糖饮料摄入量与结直肠癌（CRC）之间的关联仍存在争议。进行了一项荟萃分析以阐明含糖饮料与结直肠癌风险/死亡率之间的相关性。在PubMed、科学网、Embase、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据知识服务平台和维普中文科技期刊数据库中进行了系统的文献检索。文章限制为截至2022年3月31日可获取的任何语言。使用暴露程度最高的类别来计算合并相对风险（RR）值。合并相对风险（RR）和95%置信区间（CI）用于估计含糖饮料与结直肠癌风险和死亡率的关联。异质性用Cochran Q统计量进行评估，并用I²统计量进行量化。本荟萃分析共纳入17项研究（6项病例对照研究和11项队列研究），涉及557,391名受试者。饮用含糖饮料人群中结直肠癌发病率和死亡率的合并RR分别为1.17（95%CI：1.07 - 1.28）和1.13（95%CI：0.99 - 1.29）。在亚组分析中，发现远端结肠存在相关性，合并RR为1.41（95%CI：1.10 - 1.80）。近端结肠未发现相关性，合并RR为1.58（95%CI：0.79 - 3.17）。我们发现在北美和大洋洲，结直肠癌发病率与含糖饮料摄入量之间存在统计学显著关联，合并RR分别为1.16（95%CI：1.00 - 1.33）和1.32（95%CI：1.13 - 1.55）。在敏感性分析中，排除每项研究并计算异质性和效应大小后，含糖饮料摄入量与结直肠癌风险之间仍存在相关性。这项荟萃分析表明，含糖饮料摄入量可能会增加结直肠癌风险，与结直肠癌死亡率无关。含糖饮料摄入量增加是否会增加结直肠癌风险未来需要进一步研究。这项荟萃分析旨在表明含糖饮料摄入量与结直肠癌风险和死亡率之间的关系。共纳入17项涉及557,391名受试者的研究。结果表明，含糖饮料可能会增加结直肠癌风险，但可能与结直肠癌死亡率无关。
