title: Sugar-sweetened soft drink consumption and risk of pancreatic cancer in two prospective cohorts.
abstract: BACKGROUND
  A history of diabetes mellitus and a diet high in glycemic load are both potential risk factors for pancreatic cancer. Sugar-sweetened soft drinks are a prevalent source of readily absorbable sugars and have been associated with an increased risk of obesity and diabetes. We investigated whether higher consumption of sugar-sweetened soft drinks increases the risk of pancreatic cancer.
  
  
  METHODS
  We examined the relation between consumption of sugar-sweetened soft drinks and the development of pancreatic cancer in the Nurses' Health Study and the Health Professionals Follow-up Study. Among 88,794 women and 49,364 men without cancer at baseline, we documented 379 cases of pancreatic cancer during up to 20 years of follow-up. Soft drink consumption was first assessed at baseline (1980 for the women, 1986 for the men) and updated periodically thereafter.
  
  
  RESULTS
  Compared with participants who largely abstained from sugar-sweetened soft drinks, those who consumed more than three sugar-sweetened soft drinks weekly experienced overall a multivariate relative risk (RR) of pancreatic cancer of 1.13 [95% confidence interval (95% CI), 0.81-1.58; P for trend = 0.47]. Women in the highest category of sugar-sweetened soft drink intake did experience a significant increase in risk (RR, 1.57; 95% CI, 1.02-2.41; P for trend = 0.05), whereas there was no association between sweetened soft drink intake and pancreatic cancer among men. Among women, the risk associated with higher sugar-sweetened soft drink was limited to those with elevated body mass index (>25 kg/m(2); RR, 1.89; 95% CI, 0.96-3.72) or with low physical activity (RR, 2.02; 95% CI, 1.06-3.85). In contrast, consumption of diet soft drinks was not associated with an elevated pancreatic cancer risk in either cohort.
  
  
  CONCLUSIONS
  Although soft drink consumption did not influence pancreatic cancer risk among men, consumption of sugar-sweetened soft drinks may be associated with a modest but significant increase in risk among women who have an underlying degree of insulin resistance.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. eva.schernhammer@channing.harvard.edu
authors.forename: Eva S
authors.initials: ES
authors.lastname: Schernhammer
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Ed
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D001628:Beverages; D019422:Dietary Sucrose / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D010809:Physical Fitness; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D019422:Dietary Sucrose