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Abstract：
The association between artificial sweetener (AS) consumption and the risk of organ-specific cancers has been debated for decades. We hypothesized that AS consumption is associated with reduced risk of gastrointestinal (GI) cancers. We aimed to test this hypothesis by conducting a systematic review and meta-analysis of the association between AS and GI cancers. We searched 4 databases for comparative studies of AS consumption (exposed) versus no consumption (nonexposed) and the odds or risk of GI luminal or non-luminal cancer (primary outcome). Estimates were pooled using a random-effects model. Studies were evaluated for quality, bias, and heterogeneity. We analyzed 8 (4 prospective, 4 case-control) studies comprising data on 1,043,496 individuals, among whom 3271 pancreatic, 395 gastric, 304 esophageal, 3008 colorectal, and 598 oropharyngeal cancers occurred. While there was no significant association between AS consumption and odds of GI cancer overall, AS consumption was associated with 19% reduced likelihood of luminal GI cancer (OR 0.81, 95% CI:0.68-0.97). There was no association between AS consumption and non-luminal GI cancer. Meta-regression demonstrated no difference in effect estimates based on study type. Based on this first meta-analysis of AS and GI cancer, we demonstrated that AS consumption is associated with a significantly lower likelihood of luminal, but not non-luminal, GI cancer.
摘要：
人工甜味剂（AS）消费与器官特异性癌症风险之间的关系已经争论了几十年。我们假设AS消耗与胃肠道（GI）癌症风险降低有关。我们旨在通过对AS和GI癌症之间的关联进行系统评价和荟萃分析来检验这一假设。我们搜索了4个数据库，以比较AS消耗（暴露）与不消耗（未暴露）以及胃肠道腔或非腔癌的几率或风险（主要结果）。使用随机效应模型汇总估计值。研究进行了质量评估，偏见，和异质性。我们分析了8个(4个前瞻性，4个病例对照)研究，包括1,043,496名个体的数据，其中3271胰腺，395胃，304食道，3008结直肠，发生了598例口咽癌。虽然AS消耗和GI癌症的总体几率之间没有显着关联，AS消耗与腔内胃肠道癌可能性降低19%相关(OR0.81,95%CI:0.68-0.97)。AS消耗与非管腔胃肠道癌之间没有关联。Meta回归表明，基于研究类型的效果估计没有差异。基于对AS和GI癌的首次荟萃分析，我们证明AS的消耗与管腔的可能性显着降低有关，但不是非内腔，胃肠道癌。
