Pooled analysis of prospective studies of artificially sweetened and sugar-sweetened beverage intake and risk of liver cancer

Artificially sweetened beverages (ASBs) and sugar-sweetened beverages (SSBs) are consumed worldwide and have been linked to metabolic disorders, including obesity and type 2 diabetes, which are established risk factors associated with liver cancer. Pooled analysis of 11 prospective cohort studies comprising adults without a history of cancer at baseline examined associations between ASB and SSB consumption and risk of incident liver cancer. A total of 1 518 411 participants (mean age 57.8 ± 10.1 years; 58.2% female) were included in the analysis. During a median follow-up of 17.8 years (IQR 12.8-23.5), 2811 incident liver cancers were identified, including 1699 hepatocellular carcinoma (HCC) and 444 intrahepatic cholangiocarcinoma (ICC) cases. After multivariable adjustment, ASB intake per 1-beverage/day increase was not associated with risk of liver cancer, HCC, or ICC. SSB intake per 1-beverage/day increase was not associated with overall liver cancer risk, but was associated with increased risk of HCC (HR 1.10; 95% CI 1.03-1.18) and ICC (1.15; 1.00-1.32). There was no evidence of effect modification by diabetes status. The authors conclude that these results suggest that increased SSB consumption was associated with increased risk of HCC and ICC.