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. 2021 Mar 21;12(10):3077-3088.
doi: 10.7150/jca.51322. eCollection 2021.

Consumption of sugar-sweetened beverages and fruit juice and human cancer: a systematic review and dose-response meta-analysis of observational studies

Yuting Li  1 , Lilianagzi Guo  1 , Kaiyin He  1 , Changbing Huang  2 , Shaohui Tang  1
Affiliations

Consumption of sugar-sweetened beverages and fruit juice and human cancer: a systematic review and dose-response meta-analysis of observational studies

Yuting Li et al. J Cancer. .

Abstract

Background: Several epidemiological studies have assessed the association of sugary drinks consumption with cancer, but the results remain controversial. Objective: We performed this analysis to evaluate possible causal relationship between sugary drinks consumption and cancer risk and mortality. Methods: We searched PubMed, Embase, and Web of Science databases in English. Observational studies evaluating the association of sugary drinks intake with cancer were included. Random-effects meta-analysis was used to calculate the risk estimates. Results: A total of 71 observational articles with 32 case-control and 39 cohort studies were included in the meta-analysis. 60 addressed cancer risk, and 11 reported cancer mortality. Compared with the lowest level, the highest level of sugar-sweetened beverages (SSB) consumption showed an increased overall cancer risk (RR=1.12 95% CI: 1.06-1.19, P=0.000) and mortality (RR=1.07 95% CI: 1.01-1.14, P=0.029), and fruit juice intake showed a positive association with cancer risk in cohort studies (RR=1.06 95% CI: 1.01-1.11, P=0.013). Subgroup analyses based on cancer type indicated that risk of breast cancer, hepatocellular carcinoma, colorectal cancer, and prostatic cancer mortality had a positive association with SSB consumption. For dose-response analysis, evidence of a linear association was found between overall cancer risk and SSB or fruit juice consumption, and the risk increase by 4% for one servings/d increment in SSB intake and 14% in fruit juice. Conclusions: Our findings suggest the consumption of sugary beverages may increase the risk and mortality of cancer, especially risk of breast cancer, hepatocellular carcinoma, colorectal cancer, and prostatic cancer, and mortality of breast cancer, though the evidence was limited.

Keywords: cancer; meta-analysis; mortality; risk; sugary beverages.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Flow diagram of literature search and study selection.
Figure 2
Figure 2
Meta-analysis of SSB consumption and cancer risk by study design. Forest plot showing the summary relative ratio (RR). Weights are from random-effects analysis.
Figure 3
Figure 3
The linear dose-response association meta-analysis between SSB (A) and fruit juice (B) consumption and risks of cancer in prospective cohort studies. Weights are from random-effects analysis.
Figure 4
Figure 4
Meta-analysis of fruit juice consumption and cancer risk by study design. Forest plot showing the summary relative ratio (RR). Weights are from random-effects analysis.
Figure 5
Figure 5
Meta-analysis of SSB consumption and cancer mortality. Forest plot showing the summary relative ratio (RR). Weights are from random-effects analysis.
See this image and copyright information in PMC

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