Colorectal cancer diagnoses have increased in recent years in people under 50, and researchers are looking for reasons why. A new study led by the Washington University School of Medicine in St. Louis has found a link between drinking sugar-sweetened beverages and an increased risk of developing colorectal cancer in women under age 50. The findings suggest that heavy consumption of sugary drinks during adolescence (ages 13 to 18) and adulthood may increase disease risk.
The study, published online May 6 in the journal Gut, provides more support for public health efforts that encourage people to reduce the amount of sugar they consume.
“Colorectal cancer in younger adults remains relatively rare, but the fact that rates have increased over the past three decades – and we don’t understand why – is a major public health concern and a priority in cancer prevention,” said senior author Yin. Cao, ScD, associate professor of surgery and medicine in the department of public health sciences at Washington University. “With the increase in colorectal cancer at a younger age, the mean age for colorectal cancer diagnosis has dropped from 72 years to 66. These cancers are more advanced at diagnosis and have different characteristics than cancers from older populations.
“Our lab is funded by the National Cancer Institute (NCI) and the National Comprehensive Cancer Network to identify risk factors, the molecular landscapes and accurate screening strategies for these cancers so they can be detected and even prevented earlier,” said Cao, who also have a master’s degree in public health. “In previous work we have shown that poor nutritional quality was associated with an increased risk of early-onset colorectal cancer precursors, but we have not previously investigated specific nutrients or foods.”
Compared with women who drank less than one 8-ounce serving per week of sugar-sweetened drinks, those who drank two or more servings per day were slightly more than twice as likely to develop early-onset colon cancer, meaning it was diagnosed before the age of 50. The researchers calculated a 16% risk increase for every 8-ounce serving per day. And from age 13 to 18, a key time for growth and development, each daily serving was linked to a 32% increased risk of developing colorectal cancer before age 50.
Consumption of sugar-sweetened drinks has been linked to metabolic health problems, such as type 2 diabetes and obesity, including in children. But less is known about whether such high-sugar drinks could play a role in the increasing incidence of colorectal cancer in younger people. As with early-onset colorectal cancer, the consumption of such drinks has increased over the past 20 years, with the highest level of consumption found in adolescents and young adults aged 20 to 34 years.
The researchers analyzed data from the Nurses’ Health Study II, a large population survey that tracked the health of nearly 116,500 female nurses from 1991 to 2015. Every four years, participants answered surveys with questions about nutrition, including the types and approximate amounts of drinks they drank. Of the total participants, more than 41,000 were also asked to remember their drinking habits during their adolescence.
The researchers identified 109 early-onset colorectal cancer diagnoses among the nearly 116,500 participants.
“Despite the small number of cases, there is still a strong signal to suggest that sugar intake, especially in early life, plays a role in increasing the risk of colorectal cancer in adults before the age of 50,” said Cao, also a researcher. research member. from Siteman Cancer Center. “This study, combined with our previous work linking obesity and metabolic disorders with a higher risk of early-onset colorectal cancer, suggests that metabolic problems, such as insulin resistance, may play an important role in the development of this cancer in younger adults.”
In view of the rising rates, the American Cancer Society recently lowered the recommended age for an initial screening colonoscopy to 45, from the previously recommended age of 50 for people at moderate risk. Those with additional risk factors, such as a family history of the disease, should start even earlier, according to the guidelines.
Since the study included only female nurses, most of whom were white, more work is needed to investigate this association in people of more diverse races, ethnicities, and genders.
While sugar-sweetened drinks were associated with an increased risk of early-onset colorectal cancer, some other drinks – including milk and coffee – were associated with a reduced risk. This observational study cannot show that drinking sugary drinks causes this type of cancer or that drinking milk or coffee is protective, but the researchers said replacing sweetened drinks with unsweetened ones, such as milk and coffee, is a better choice. for a longer period of time. term health.
“Given this data, we recommend that people avoid sugar-sweetened drinks and instead opt for drinks such as milk and coffee without sweeteners,” Cao said.
Co-authors of the study include Ebunoluwa Otegbeye, MD, a general surgeon at Washington University who works in the Cao laboratory. Otegbeye is supported by the surgical oncology, basic science and translational research training program. Contributors include researchers from the Harvard TH Chan School of Public Health and Harvard Medical School.
This work was supported by the National Institutes of Health (NIH), grant numbers U01 CA176726, R01 CA205406, R21 CA230873, R01 CA151993, R35 CA197735, R35 CA253185, R03 CA197879, R21 CA222940, R37 CA246175, K07 CA218377, and T0732; the Ministry of Defense, grant number CA160344; the Project P fund; the Stuart and Suzanne Steele MGH Research Scholarship; and an Investigator Initiated Grant from the American Institute for Cancer Research.
Hur J, et al. Intake of sugar-sweetened beverages during adulthood and adolescence and the risk of early-onset colorectal cancer in women. Intestine. May 6, 2021.
Washington University School of Medicine’s 1,500 faculty doctors are also the medical staff of the Barnes Jewish and St. Louis Children’s Hospitals. The School of Medicine is a leader in medical research, education, and patient care, consistently ranked among the top medical schools in the country, according to US News & World Report. Because of its links with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is affiliated with BJC HealthCare.