Sugary Drink Consumption and Subsequent Colorectal Cancer Risk: The Japan Public Health Center-Based Prospective Cohort Study

Cancer Epidemiol Biomarkers Prev. 2021 Apr;30(4):782-788. doi: 10.1158/1055-9965.EPI-20-1364. Epub 2021 Feb 9.


Background: Most studies examining the associations of sugary drink consumption on colorectal cancer risk have been conducted in Western populations.

Methods: This study consisted of 74,070 participants in the Japan Public Health Center-based Prospective Study who completed a food frequency questionnaire (1995-1999). The participants were followed until December 2013 to investigate the associations between sugary drink consumption and colorectal cancer risk using Cox proportional hazards regression models.

Results: Among the 74,070 participants, mean age was 56.5 years at baseline, with a mean body mass index (BMI) of 23.5 and a mean daily consumption of 286 mL/day for men and 145 mL/day for women. During a follow-up of 15 years, 1,648 colorectal cancer cases were identified. No overall greater risk of colorectal cancer was observed among men [multivariable HR = 0.84; 95% confidence of interval (CI), 0.70-1.02; ≥254 mL/day vs. nonconsumers] and women (HR = 1.20; 95% CI, 0.96-1.50, ≥134 mL/day vs. nonconsumers). Sugary drink consumption was associated with colon cancer among women (HR = 1.36; 95% CI, 1.03-1.78, ≥134 mL/day vs. nonconsumers). HRs for proximal colon cancer among women who consumed sugary drinks, as compared with nonconsumers, were 1.47 (95% CI, 1.03-2.10) for sugary drink consumption less than 134 mL/day, and 1.45 (95% CI, 1.01-2.09) for at least 134 mL/day.

Conclusions: In this large prospective cohort of Japanese with a moderate sugary drink consumption level and low prevalence of obesity, we observed a 36% increased risk of colon cancer in women.

Impact: Our findings highlight the importance of subsite- and sex-specific investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colorectal Neoplasms / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk
  • Risk Factors
  • Sex Factors
  • Sugar-Sweetened Beverages / adverse effects*