Consumption of Artificially-sweetened Soft Drinks and Risk of Gastrointestinal Cancer: A Meta-analysis of Observational Studies
Abstract Objective: There remain inconclusive findings from previous observational epidemiological studies on whether consumption of artificially-sweetened soft drinks (ASSDs) increases the risk of gastrointestinal (GI) cancer. We investigated the associations between the consumption of ASSDs and the risk of GI cancer using a meta-analysis. Design: Systematic review and meta-analysis. Setting: PubMed and EMBASE were searched using keywords until May 2020 to identify observational epidemiological studies on the association between the consumption of ASSDs and the risk of GI cancer. Subjects: Twenty-one case-control studies and 17 cohort studies with 12,397 cancer cases and 2,474,452 controls. Results: In the random-effects meta-analysis of all the studies, consumption of ASSDs was not significantly associated with the risk of overall GI cancer (odds ratio (OR)/relative risk (RR), 1.02; 95% CI, 0.92-1.14). There was no significant association between the consumption of ASSDs and the risk of overall GI cancer in the subgroup meta-analyses by study design (case-control studies: OR, 0.95; 95% CI, 0.82-1.11; cohort studies: RR, 1.14; 95% CI, 0.97-1.33). In the subgroup meta-analysis by type of cancer, consumption of ASSDs was significantly associated with the increased risk of liver cancer (OR/RR, 1.28; 95% CI,1.03-1.58). Conclusions: The current meta-analysis of observational epidemiological studies suggests that overall, there is no significant association between the consumption of ASSDs and the risk of GI cancer.