Morrison A S, Buring J E
N Engl J Med. 1980 Mar 6;302(10):537-41. doi: 10.1056/NEJM198003063021001.
We evaluated the relation between cancer of the lower urinary tract and the use of artificial sweeteners in a case-control study of 592 patients with lower-urinary-tract cancer (94 per cent of whom had a bladder tumor) and 536 controls chosen from the general population of the study area. A history of use or artificial sweeteners and exposure to other known or suspected risk factors was determined by interview. In those who had used dietetic beverages and in those who had used sugar substitutes, the relative risk of lower-urinary-tract cancer was estimated as 0.9 (0.7 to 1.2, 95 per cent confidence interval), as compared with 1 in nonusers of artificial sweeteners. Among men, the relative risk was 0.8 (0.6 to 1.1) in those who had used dietetic beverages and 0.8 (0.5 to 1.1) in those who had used sugar substitutes. Among women, the corresponding relative risks were 1.6 (0.9 to 2.7) and 1.5 (0.9 to 2.6). Increasing frequency of duration of use of artificial sweeteners was not consistently associated with increasing relative risk. This study suggests that, as a group, users of artificial sweeteners have little or no excess risks of cancer of the lower urinary tract.
在一项病例对照研究中，我们评估了下尿路癌症与人工甜味剂使用之间的关系。该研究纳入了592名下尿路癌症患者（其中94%患有膀胱肿瘤）以及从研究区域的普通人群中选取的536名对照。通过访谈确定人工甜味剂的使用史以及其他已知或疑似风险因素的暴露情况。与未使用人工甜味剂的人群相比，饮用减肥饮料的人群以及使用糖替代品的人群中下尿路癌症的相对风险估计为0.9（95%置信区间为0.7至1.2）。在男性中，饮用减肥饮料的人群相对风险为0.8（0.6至1.1），使用糖替代品的人群相对风险为0.8（0.5至1.1）。在女性中，相应的相对风险分别为1.6（0.9至2.7）和1.5（0.9至2.6）。人工甜味剂使用频率或使用时长的增加与相对风险的增加并无一致关联。这项研究表明，总体而言，人工甜味剂使用者患下尿路癌症的额外风险很小或没有。
