title: Association of sugary beverages with survival among patients with cancers of the upper aerodigestive tract.
abstract: The role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients.
  
  
  
  The association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case-control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders.
  
  
  
  A total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32-2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility.
  
  
  
  These findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers.
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA.
authors.forename: Fayth L
authors.identifier: 0000-0002-9394-0047
authors.initials: FL
authors.lastname: Miles
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA.
authors.forename: Shen-Chih
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Departments of Epidemiology and Environmental Health Sciences, School of Public Health, and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Hal
authors.initials: H
authors.lastname: Morgenstern
authors.affiliation: Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Tashkin
authors.affiliation: Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Jian-Yu
authors.initials: JY
authors.lastname: Rao
authors.affiliation: Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Cozen
authors.affiliation: Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mack
authors.affiliation: Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
authors.forename: Qing-Yi
authors.initials: QY
authors.lastname: Lu
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA. zfzhang@ucla.edu.|Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA. zfzhang@ucla.edu.|Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA. zfzhang@ucla.edu.
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001628:Beverages / Q000009:adverse effects*; D016022:Case-Control Studies; D019422:Dietary Sucrose / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000209:etiology / Q000401:mortality*; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D019422:Dietary Sucrose
keywords: Case–control; Cox regression; Head and neck cancers; Sugary beverages; Survival