Sugar-sweetened beverage and sugar consumption and colorectal cancer incidence and mortality according to anatomic subsite
Menée à partir de données 1984-2014 des cohortes "the Nurses’ Health Study" et "the Health Professionals Follow-Up Study" portant sur 121 111 personnes, cette étude analyse l'association entre la consommation de boissons édulcorées ou de fructose et l'incidence du cancer colorectal (2 733 cas) ainsi que la mortalité spécifique par sous-site anatomique (901 décès)
Recent preclinical research strongly suggests that dietary sugars can enhance colorectal tumorigenesis by direct action, particularly in the proximal colon that unabsorbed fructose reaches.We aimed to examine long-term consumption of sugar-sweetened beverages (SSBs) and total fructose in relation to incidence and mortality of colorectal cancer (CRC) by anatomic subsite.We followed 121,111 participants from 2 prospective US cohort studies, the Nurses’ Health Study (1984–2014) and Health Professionals Follow-Up Study (1986–2014), for incident CRC and related death. Cox proportional hazards regression was used to compute HRs and 95% CIs.During follow-up, we documented 2733 incident cases of CRC with a known anatomic location, of whom 901 died from CRC. Positive associations of SSB and total fructose intakes with cancer incidence and mortality were observed in the proximal colon but not in the distal colon or rectum (Pheterogeneity ≤ 0.03). SSB consumption was associated with a statistically significant increase in the incidence of proximal colon cancer (HR per 1-serving/d increment: 1.18; 95% CI: 1.03, 1.34; Ptrend = 0.02) and a more pronounced elevation in the mortality of proximal colon cancer (HR: 1.39; 95% CI: 1.13, 1.72; Ptrend = 0.002). Similarly, total fructose intake was associated with increased incidence and mortality of proximal colon cancer (HRs per 25-g/d increment: 1.18; 95% CI: 1.03, 1.35; and 1.42; 95% CI: 1.12, 1.79, respectively). Moreover, SSB and total fructose intakes during the most recent 10 y, rather than those from a more distant period, were associated with increased incidence of proximal colon cancer.SSB and total fructose consumption were associated with increased incidence and mortality of proximal colon cancer, particularly during later stages of tumorigenesis.