Sugar-Sweetened Beverage Consumption May Increase Risk for Early-Onset Colorectal Cancer

Concept of the equivalence in azucar of a drink of tin of refreshment sweetened
Investigators assessed the association between intake of sugar-sweetened beverages in adolescence and adulthood and the risk for early-onset colorectal cancer.

Sugar-sweetened beverage (SSB) consumption may contribute to the rising incidence of early-onset colorectal cancer (EO-CRC), according to a study published in Gut.

Both the incidence of EO-CRC (age <50 years at diagnosis) and SSB consumption (eg, soft drinks, fruit drinks, sports drinks, and energy drinks) among adolescents and young adults have been increasing over the past 2 decades. The association between EO-CRC risk and SSB consumption has not been thoroughly investigated. Thus, researchers examined data from the Nurses’ Health Study II (1991-2015), a large, prospective United States cohort of young women, to explore the association between intake of sweetened beverages in adulthood and adolescence and the risk for EO-CRC.

Among 95,464 women who had reported adulthood beverage intake using validated food frequency questionnaires (FFQs) every 4 years, a subset of 41,272 participants reported beverage intake between ages 13 and 18 years using a high school-FFQ in 1998.

The researchers noted 109 cases of EO-CRC over 24 years of follow-up. Women who recorded higher intake of SSB in adulthood were generally less physically active, and more likely to undergo lower endoscopy procedures, use nonsteroidal anti-inflammatory drugs, and to consume red or processed meats. Participants who recorded greater SSB consumption during adolescence were more likely to take part in unhealthy diets and lifestyles.   

Compared with individuals who consumed less than 1 serving per week of SSBs in adulthood, women who consumed 2 or more servings per day had a more than twice as high risk for EO-CRC (P =.02), with a 16% higher risk per serving per day increase.

The researchers noted that each serving per day increment of SSB intake at ages 13 to 18 years was associated with a 32% higher risk for EO-CRC. By replacing each serving per day of adulthood SSB intake with that of artificially sweetened beverages, coffee, reduced fat milk, or total milk, the risk for EO-CRC was decreased by 17% to 36%.

This study was limited by the possibility of residual or unmeasured confounding. Additionally, the majority of the study population consisted of White women, limiting the generalizability of the results.

“In conclusion, in this large prospective cohort study of [United States] women, higher SSB intake in adulthood and adolescence was associated with a substantially higher risk of EO-CRC,” stated the authors. Thus, these findings reinforce the public health importance of limiting SSB intake for better health outcomes.


Hur J, Otegbeye E, Joh H-K, et al. Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women. Gut. 2021;70(12):2330–2336. doi: 10.1136/gutjnl-2020-323450