Hauan Marie, Rylander Charlotta, Skeie Guri
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
IARC Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
BMC Cancer. 2025 Apr 1;25(1):592. doi: 10.1186/s12885-025-13835-4.
Colorectal cancer (CRC) is the third most common type of cancer worldwide, with Norwegian women having the highest incidence rate of colon cancer in 2022. The consumption of sweet beverages is a suggested modifiable risk factor for CRC; however, current evidence is limited and inconclusive.
To assess the associations between the intake of sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and juice and the risk of overall and subsite-specific CRC among Norwegian women.
In this prospective cohort study, we included 73,921 participants aged 41-61 years at baseline. Information on sweet beverage consumption was collected using self-reported food frequency questionnaires at two time points between 1998 and 2014. We used Cox proportional hazards models to estimate hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) for the associations between sweet beverage consumption and the risk of overall CRC, proximal colon cancer, distal colon cancer, and rectal cancer.
During a mean follow-up time of 16.5 years from baseline, 1,187 women were diagnosed with CRC. Compared to no consumption, juice consumption was inversely associated with overall CRC risk (HR = 0.81, 95% CI: 0.67-0.98; p-trend = 0.025), colon cancer (HR = 0.73, 95% CI: 0.58-0.94; p-trend = 0.015) and proximal colon cancer (HR = 0.71, 95% CI: 0.52-0.99; p-trend = 0.065) after adjusting for age, education, and diabetes status at baseline. No associations were observed between juice consumption and distal colon cancer or rectal cancer risk, or between the intake of SSBs or ASBs and CRC.
We observed no substantial association between the intake of SSBs or ASBs and the risk of CRC or cancer in colorectal subsites in our cohort of Norwegian women. Conversely, our results indicate that juice consumption is associated with a reduced risk of CRC, particularly in the colon. These results warrant further investigation in larger cohorts with power to detect possible differences in cancer risk across colorectal subsites, especially as patterns of sweet beverage consumption are changing.
结直肠癌（CRC）是全球第三大常见癌症类型，2022年挪威女性的结肠癌发病率最高。饮用甜饮料是一种被认为可改变的结直肠癌风险因素；然而，目前的证据有限且尚无定论。
评估挪威女性中含糖饮料（SSB）、人工甜味饮料（ASB）和果汁的摄入量与总体及特定部位结直肠癌风险之间的关联。
在这项前瞻性队列研究中，我们纳入了73921名基线年龄在41至61岁之间的参与者。在1998年至2014年期间的两个时间点，通过自我报告的食物频率问卷收集甜饮料消费信息。我们使用Cox比例风险模型来估计甜饮料消费与总体结直肠癌、近端结肠癌、远端结肠癌和直肠癌风险之间关联的风险比（HR）及相应的95%置信区间（CI）。
从基线开始平均随访16.5年期间，1187名女性被诊断患有结直肠癌。与不饮用相比，在调整基线时的年龄、教育程度和糖尿病状态后，饮用果汁与总体结直肠癌风险呈负相关（HR = 0.81，95% CI：0.67 - 0.98；p趋势 = 0.025），与结肠癌（HR = 0.73，95% CI：0.58 - 0.94；p趋势 = 0.015）和近端结肠癌（HR = 0.71，95% CI：0.52 - 0.99；p趋势 = 0.065）呈负相关。未观察到饮用果汁与远端结肠癌或直肠癌风险之间存在关联，也未观察到饮用SSB或ASB与结直肠癌之间存在关联。
在我们的挪威女性队列中，未观察到饮用SSB或ASB与结直肠癌风险或结直肠特定部位癌症之间存在实质性关联。相反，我们的结果表明饮用果汁与结直肠癌风险降低有关，尤其是在结肠癌方面。这些结果值得在更大的队列中进一步研究，以有能力检测结直肠各部位癌症风险的可能差异，特别是随着甜饮料消费模式的变化。
