Consumption of sugar and sugar-sweetened foods and the risk of pancreatic cancer in a prospective study

Background: Emerging evidence indicates that hyperglycemia and hyperinsulinemia may be implicated in the development of pancreatic cancer. Frequent consumption of sugar and high-sugar foods may increase the risk of pancreatic cancer by inducing frequent postprandial hyperglycemia, increasing insulin demand, and decreasing insulin sensitivity. Objective: The objective of the study was to examine prospectively the association of the consumption of added sugar (ie, sugar added to coffee, tea, cereals, etc) and of high-sugar foods with the risk of pancreatic cancer in a population-based cohort study of Swedish women and men. Design: A food-frequency questionnaire was completed in 1997 by 77 797 women and men aged 45-83 y who had no previous diagnosis of cancer or history of diabetes. The participants were followed through June 2005. Results: During a mean follow-up of 7.2 y, we identified 131 incident cases of pancreatic cancer. The consumption of added sugar, soft drinks, and sweetened fruit soups or stewed fruit was positively associated with the risk of pancreatic cancer. The multivariate hazard ratios for the highest compared with the lowest consumption categories were 1.69 (95% CI: 0.99, 2.89; P for trend = 0.06) for sugar, 1.93 (1.18, 3.14; P for trend = 0.02) for soft drinks, and 1.51 (0.97, 2.36; P for trend 0.05) for sweetened fruit soups or stewed fruit. Conclusion: High consumption of sugar and high-sugar foods may be associated with a greater risk of pancreatic cancer.