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High daily intake of sweetened beverages, sucrose increase risk for biliary tract cancer
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Adults who consumed more than two sugar-sweetened beverages each day appeared to experience an increased risk for biliary tract cancer, according to the result of a Swedish national prospective cohort study.
This risk was especially apparent for gallbladder cancer, results showed.
“Little is known about the causes of biliary tract cancer, but emerging evidence indicates that excess body weight and type 2 diabetes may increase the risk of biliary tract cancer,” Susanna C. Larsson, PhD, associate professor in the unit of nutritional epidemiology at Institute of Environmental Medicine of Karolinska Institutet in Stockholm, Sweden, and colleagues wrote. “Consumption of sugar-sweetened beverages, such as soft drinks, raises blood glucose concentration and has been associated with weight gain and with increased risk of the metabolic syndrome and type 2 diabetes in most but not all studies.”
Researchers evaluated the hypothesis that sweetened beverage consumption is associated with increased risk for biliary tract cancer. In a secondary analysis, researchers evaluated sucrose intake and its association with biliary tract cancer risk.
The analysis included data from 70,832 Swedish adults (55.9% men; age range, 45-83 years) from the Swedish Mammography Cohort or the Cohort of Swedish Men who completed a baseline food frequency questionnaire. Exclusion criteria included previous history of cancer or diabetes.
Researchers grouped patients based on sweetened beverage consumption into the following cohorts:
- reference group: zero sweetened beverages per day (n = 37,405; 52% men);
- middle-low consumption: 0.1 to 0.4 sweetened beverages per day (n = 13,383; 50.8% men);
- middle-high consumption: 0.5 to 1.9 sweetened beverages per day (n = 12,716; 64.4% men); and
- high consumption: two or more sweetened beverages per day (n = 7,328; 61.1% men).
Patient-reported daily sucrose intake corresponded with daily sweetened beverage consumption for each consumption group (reference group, 20.2 g/day; middle-low group, 31.9 g/day; middle-high group, 42.6 g/day; high group, 67.2 g/day).
The median follow-up was 13.4 years.
Researchers used the Swedish Cancer Registry to calculate biliary tract cancer incidence data.
A total of 127 participants received a diagnosis of extrahepatic biliary tract cancer, 71 of which were gallbladder cancer. Twenty-one participants received a diagnosis of intrahepatic biliary tract cancer.
Researchers conducted multivariate analyses that included patient-reported baseline data on BMI, physical activity, smoking, alcohol consumption and education.
Results showed patients in the high sweetened beverage consumption group had a significantly increased risk for extrahepatic biliary tract cancer (20 diagnoses; HR = 1.79; 95% CI, 10.2-3.13) and gallbladder cancer (10 diagnoses; HR = 2.24; 95% CI, 1.02-4.89). The risk was not significant for intrahepatic biliary tract cancer (HR = 1.69; 95% CI, 0.41-7.03).
In the secondary analysis, sucrose intake appeared to be associated with a statistically significant increased risk for gallbladder cancer high consumption (HR = 2.55; 95% CI, 1.08-6) participants.
Researchers acknowledge these findings may be limited because sweetened-beverage consumption was collected at baseline only, and because there was no distinction between artificially sweetened beverages and sugar-sweetened beverages.
“Obesity and type 2 diabetes are not as strongly associated with gallbladder cancer risk as blood glucose concentration,” Larsson and colleagues wrote. “The biological mechanisms that may link elevated blood glucose concentration to gallbladder cancer risk are unclear, but growth-promoting effects of insulin and insulin-like growth factors are possible mechanisms.” – by Nick Andrews
Disclosure: The study was funded by the Swedish Research Council/Council for Research Infrastructures, Strategic Research Area in Epidemiology at Karolinska Institutet and the Swedish Cancer Foundation.
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