4.5 Article

Intake of artificial sweeteners among adults is associated with reduced odds of gastrointestinal luminal cancers: a meta-analysis of cohort and case-control studies

Journal

NUTRITION RESEARCH
Volume 93, Issue -, Pages 87-98

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.nutres.2021.07.007

Keywords

Meta-analysis; Systematic review; Epidemiology; Environment and public health; Digestive system neoplasm; Nutrition therapy

Funding

  1. Agency for Healthcare Research (AHRQ)
  2. Quality and Patient-Centered Outcomes Research Institute (PCORI) [K12 HS026395]
  3. Veterans Affairs Career Development Award [ICX002027A01]
  4. American Gastroenterological Association Research Scholar Award

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After conducting a systematic review and meta-analysis of 8 studies, it was found that while there was no significant association between artificial sweetener (AS) consumption and overall gastrointestinal cancer risk, AS consumption was associated with a 19% reduced likelihood of luminal GI cancer.
The association between artificial sweetener (AS) consumption and the risk of organ-specific cancers has been debated for decades. We hypothesized that AS consumption is associated with reduced risk of gastrointestinal (GI) cancers. We aimed to test this hypothesis by conducting a systematic review and meta-analysis of the association between AS and GI cancers. We searched 4 databases for comparative studies of AS consumption (exposed) versus no consumption (nonexposed) and the odds or risk of GI luminal or non-luminal cancer (primary outcome). Estimates were pooled using a random-effects model. Studies were evaluated for quality, bias, and heterogeneity. We analyzed 8 (4 prospective, 4 case-control) studies comprising data on 1,043,496 individuals, among whom 3271 pancreatic, 395 gastric, 304 esophageal, 3008 colorectal, and 598 oropharyngeal cancers occurred. While there was no significant association between AS consumption and odds of GI cancer overall, AS consumption was associated with 19% reduced likelihood of luminal GI cancer (OR 0.81, 95% CI:0.68-0.97). There was no association between AS consumption and non-luminal GI cancer. Meta-regression demonstrated no difference in effect estimates based on study type. Based on this first meta-analysis of AS and GI cancer, we demonstrated that AS consumption is associated with a significantly lower likelihood of luminal, but not non-luminal, GI cancer. Published by Elsevier Inc.

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