Session/Event: Diet and Cancer (Oral 7)

(OR07-01-22) Association Between Sugar-Sweetened Beverage Intake and Liver Cancer Risk in the Women's Health Initiative

On Demand

Presenting Author(s)

Longgang Zhao, MS

PhD candidate
University of South Carolina
Columbia, South Carolina, United States

Disclosure: Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

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Co-Author(s)

MC

Mace Coday

University of Tennessee Health Science Center
DG

David O. Garcia

University of Arizona, Mel and Enid Zuckerman College of Public Health
XL

Xinyi Li

Harvard T.H. Chan School of Public Health
ML

Melissa Lopez-Pentecost

University of Arizona, College of Medicine
JoAnn E. Manson, MD, DrPH

Chief, Division of Preventive Medicine
Brigham and Women's Hospital, Harvard Medical School
Boston, Massachusetts, United States
KM

Katherine A. McGlynn, PhD

National Cancer Institute
Bethesda, Maryland, United States
YM

Yasmin Mossavar-Rahmani

Albert Einstein College of Medicine
MN

Michelle J. Naughton

The Ohio State University, College of Medicine
NS

Nazmus Saquib, PhD

Sulaiman Al Rajhi University
Al Bukayriah, Al Qasim, Saudi Arabia
HS

Howard Sesso, Associate Professor of Medicine

Brigham and Womens Hospital
Boston, Massachusetts, United States
AS

Aladdin H. Shadyab, PhD

Assistant Professor
University of California
San Diego, California, United States
MS

Michael S. Simon

Karmanos Cancer Institute at Wayne State University
LS

Linda G. Snetselaar, PhD, RD

University of Iowa
Iowa City, Iowa, United States
FT

Fred K. Tabung, PhD, MSPH

Assistant Professor
Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
LT

Lesley F. Tinker, PhD, RD

Nutrition Scientist
Fred Hutchinson Cancer Research Center
Seattle, Washington, United States
Deirdre K. Tobias, ScD

Assistant Professor
Brigham and Women's Hospital Division of Preventive Medicine, Department of Medicine; Harvard TH Chan School of Public Health
Boston, Massachusetts, United States
TV

Trang VoPham

Fred Hutchinson Cancer Research Center & University of Washington School of Public Health
XZ

Xuehong Zhang

Brigham and Women's Hospital and Harvard Medical School & Harvard T.H. Chan School of Public Health

Objectives: Intake of sugar-sweetened beverage (SSB), a postulated risk factor for obesity, diabetes, and cardiovascular disease, may drive insulin resistance and inflammation which are strongly implicated in liver carcinogenesis. However, evidence on the association between SSB intake and liver cancer is scarce. We hypothesized that higher SSB intake would be associated with a greater risk of liver cancer.

Methods: We included 90,504 women aged 50-79 years from the Women's Health Initiative Observational Study and Clinical Trials excluding Dietary Modification Trial participants. SSB intake was defined as the sum of soft drinks and fruit drinks (1 serving=one 12 fl. oz can or 355 ml), which was assessed by a validated food frequency questionnaire administered at baseline between 1993 and 1998. Incident liver cancers were reported by self-administered questionnaires and further confirmed by medical record review. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for age, race and ethnicity, education, alcohol intake, smoking status, body mass index, non-steroidal anti-inflammatory drug use, physical activity, total caloric intake, and history of diabetes.

Results: After a median of 18.7 years follow-up, 205 women had confirmed liver cancer. Approximately 7.3% of women consumed ≥1 serving/day of SSB. Higher SSB intake was associated with a 78% greater risk of liver cancer (HR _{≥1/day vs never to < 3/month}=1.78, 95%CI=1.09-2.95, P<sub> linear trend=0.007) as compared to intake of < 3 servings/month. Non-statistically significant positive associations with liver cancer were observed for fruit drinks (HR _{≥1/day vs never to < 3/month}=1.55, 95%CI=0.88-2.75) and soft drinks (HR _{≥1/day vs never to < 3/month}=1.73, 95%CI=0.76-3.94). Results were similar after further adjustment for coffee/tea intake, or history of liver diseases, or when liver cancer cases diagnosed within the first 2 years of follow-up or those with history of diabetes were excluded.

Conclusions: Our findings suggest SSB as a potential modifiable risk factor for liver cancer in postmenopausal women. Studies in men and diverse populations are needed to examine these associations more comprehensively.

Funding Sources: The WHI study is funded by the National Institute of Health.