title: Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants.
abstract: BACKGROUND
  The effect of artificial sweetener consumption on cancer risk has been debated in animal models for over four decades. To further investigate this relationship, this study aims to synthesise results from several of the most recent studies in humans.
  
  
  METHODS
  An online literature search was performed in MEDLINE from 2003 to 2014 using Ovid, PubMed, Web of Science, and Scopus using keywords 'artificial', 'sweetener' and 'cancer'. Ninety-two results were then manually assessed for eligibility. Studies were included if the relationship between artificial sweeteners and cancer was their central hypothesis, and if they adjusted for age, gender, smoking status and body mass index. Extracted data included study design, patient characteristics, outcome measure and results.
  
  
  RESULTS
  In the five publications that satisfied the inclusion criteria, significant direct associations with artificial consumption were found for laryngeal (odds ratio, OR 2.34, 95% CI: 1.20-4.55), urinary tract tumours (OR 2.12, 95% CI: 1.22-3.89), non-Hodgkin lymphoma in men (RR 1.31, 95% CI: 1.01-1.72), multiple myeloma in men (RR 2.02, 95% CI: 1.20-3.40) and leukaemia (RR 1.42, 95% CI: 1.00-2.02). Inverse relationships were found in breast (OR 0.70, 95% CI: 0.54-0.91, p trend = 0.015) and ovarian (OR 0.56, 95% CI: 0.38-0.81, p trend < 0.001) cancers.
  
  
  CONCLUSIONS
  The statistical value of this review is limited by the heterogeneity and observational designs of the included studies. Although there is limited evidence to suggest that heavy consumption may increase the risk of certain cancers, overall the data presented are inconclusive as to any relationship between artificial sweeteners and cancer.
authors.affiliation: GKT School of Medical Education, King's College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.affiliation: MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Froghi
authors.affiliation: MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D001943:Breast Neoplasms / Q000139:chemically induced; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000139:chemically induced; D007938:Leukemia / Q000139:chemically induced; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced; D008297:Male; D009101:Multiple Myeloma / Q000139:chemically induced; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D064887:Observational Studies as Topic; D010051:Ovarian Neoplasms / Q000139:chemically induced; D013549:Sweetening Agents / Q000009:adverse effects*
chemical_list: D013549:Sweetening Agents