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Review
. 2023 Mar:139:105369.
doi: 10.1016/j.yrtph.2023.105369. Epub 2023 Mar 3.

Non-sugar sweeteners and cancer: Toxicological and epidemiological evidence

Sofia Pavanello  1 , Angelo Moretto  2 , Carlo La Vecchia  3 , Gianfranco Alicandro  4
Affiliations
Free article
Review

Non-sugar sweeteners and cancer: Toxicological and epidemiological evidence

Sofia Pavanello et al. Regul Toxicol Pharmacol. 2023 Mar.
Free article

Abstract

Several toxicological and epidemiological studies were published during the last five decades on non-sugar sweeteners (NSS) and cancer. Despite the large amount of research, the issue still continues to be of interest. In this review, we provided a comprehensive quantitative review of the toxicological and epidemiological evidence on the possible relation between NSS and cancer. The toxicological section includes the evaluation of genotoxicity and carcinogenicity data for acesulfame K, advantame, aspartame, cyclamates, saccharin, steviol glycosides and sucralose. The epidemiological section includes the results of a systematic search of cohort and case-control studies. The majority of the 22 cohort studies and 46 case-control studies showed no associations. Some risks for bladder, pancreas and hematopoietic cancers found in a few studies were not confirmed in other studies. Based on the review of both the experimental data on genotoxicity or carcinogenicity of the specific NSS evaluated, and the epidemiological studies it can be concluded that there is no evidence of cancer risk associated to NSS consumption.

Keywords: Artificial sweeteners; Cancer; Epidemiology; Non-sugar sweetened beverages; Toxicology.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Melete srl provided financial support through a grant form ISA (International Sweeteners Association). The conclusions are those of the authors; the sponsors did not have any role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.