Gomez-Castillo Luis, Cushing-Haugen Kara L, Useche Mateo, Norouzi Armita, Rizvi Zain, Ferrandino Rocco, Futran Neal, Marchiano Emily, Rodriguez Tina, Harris Holly R, Barber Brittany
University of Washington School of Medicine, Seattle.
Public Health Sciences Division, Fred Hutch Cancer Center, Seattle, Washington.
JAMA Otolaryngol Head Neck Surg. 2025 May 1;151(5):450-457. doi: 10.1001/jamaoto.2024.5252.
The incidence of oral cavity cancer (OCC) is increasing among nonsmokers and young individuals without traditional risk factors worldwide. High sugar-sweetened beverage (SSB) intake is associated with various gastrointestinal cancers, but its association with OCC has not been explored.
To evaluate the association between SSB intake and the risk of OCC among smoking and nonsmoking women participating in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII).
DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study analyzed data from women in the NHS (follow-up, 1986-2016) and NHSII (follow-up, 1991-2017) after excluding those with a history of cancer, implausible caloric intake, or missing SSB intake data. Participants were followed up until the diagnosis of OCC. Data analysis was performed from July 2023 to June 2024.
SSB intake, quantified by frequency of consumption ranging from less than 1 SSB monthly to 1 or more SSBs daily.
Cox proportional hazards regression models with age and questionnaire period as the time scale were used to estimate hazard ratios (HRs) and 95% CIs associated with the development of OCC for each category of SSB intake, with less than 1 SSB per month as the reference group.
A total of 162 602 women (mean [SD] age, 43.0 [9.9] years) were evaluated. During 30 years of follow-up, 124 invasive OCC cases were documented. In multivariable-adjusted models, participants consuming 1 or more SSB daily (5 people per 100 000 population) had a 4.87 times (95% CI, 2.47-9.60 times) higher risk of OCC compared with those consuming less than 1 SSB monthly (2 people per 100 000 population), increasing the rate of OCC to 3 more people per 100 000 population. When restricted to both nonsmokers or light smokers and nondrinkers or light drinkers, the risk of OCC was 5.46 times (95% CI, 1.75-17.07 times) higher, increasing the rate of OCC to 3 more people per 100 000 population.
In this study, high SSB intake was associated with a significantly increased risk of OCC in women, regardless of smoking or drinking habits, yet with low baseline risk. Additional studies are needed in larger cohorts, including males, to validate the impact of these findings.
在全球范围内，口腔癌（OCC）在非吸烟者和无传统风险因素的年轻人中的发病率正在上升。高糖饮料（SSB）的摄入与多种胃肠道癌症有关，但其与口腔癌的关联尚未得到研究。
评估参与护士健康研究（NHS）和护士健康研究II（NHSII）的吸烟和非吸烟女性中，SSB摄入量与口腔癌风险之间的关联。
设计、背景和参与者：这项纵向队列研究分析了NHS（随访时间为1986 - 2016年）和NHSII（随访时间为1991 - 2017年）中女性的数据，排除了有癌症病史、热量摄入不合理或缺少SSB摄入量数据的女性。参与者随访至口腔癌诊断。数据分析于2023年7月至2024年6月进行。
SSB摄入量，通过每月饮用少于1次SSB至每天饮用1次或更多次SSB的消费频率进行量化。
以年龄和问卷周期为时间尺度的Cox比例风险回归模型，用于估计每类SSB摄入量与口腔癌发生相关的风险比（HRs）和95%置信区间（CIs），以每月饮用少于1次SSB作为参照组。
共评估了162602名女性（平均[标准差]年龄，43.0[9.9]岁）。在30年的随访期间，记录了124例侵袭性口腔癌病例。在多变量调整模型中，每天饮用1次或更多次SSB的参与者（每10万人口中有5人）患口腔癌的风险是每月饮用少于1次SSB的参与者（每10万人口中有2人）的4.87倍（95% CI，2.47 - 9.60倍），使每10万人口中口腔癌发病率增加3人。当仅限于非吸烟者或轻度吸烟者以及不饮酒者或轻度饮酒者时，口腔癌风险高5.46倍（95% CI，1.75 - 17.07倍），使每10万人口中口腔癌发病率增加3人。
在本研究中，无论吸烟或饮酒习惯如何，高SSB摄入量与女性患口腔癌风险显著增加相关，但基线风险较低。需要在包括男性在内的更大队列中进行进一步研究，以验证这些发现的影响。
