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Study: Soda drinkers at increased risk of pancreatic cancer

A study published today in the journal Cancer Epidemiology, Biomarkers & Prevention finds that people who drink two caloric soft drinks a week have nearly double the risk of developing pancreatic cancer when compared to those who drink less.

The research tracked 60,524 men and women in the Singapore Chinese Health Study for 14 years and found that the soft-drinkers increased their risk of contracting the deadly cancer by 87 percent. The relationship held up even when smoking and a handful of other habits were taken into account. The study did not look at consumption of diet soda; soft drinks were defined as "sugar-sweetened carbonated beverages."

The study, funded by the National Cancer Institute, notes that lifestyles in Singapore have much in common with those in the U.S. and that the findings should apply to Caucasians as well as to the Asians who were tracked.

Lead author Mark Pereira, an associate professor in the School of Public Health at the University of Minnesota, suggests that the high level of sugar in sodas may boost insulin levels in the body, which in turn might spur the development of pancreatic cancer cells.

But no such connection was found between drinking fruit juices, whose sugar content often matches that of soft drinks.

The findings, while provocative and frightening, could use some perspective. First, the total number of pancreatic cancer cases found over the 14 years of the study was just 140. Of those, 18 occurred among people who'd reported consuming two or more sodas per week, and 12 among those who drank less than two; 110 occurred in people who'd reported drinking no soda.

The study acknowledges that those small numbers might make the association a little more tenuous, "limiting the power" of the data and "giving potential to a chance association." It also cites four earlier studies that examined the soda-pancreatic cancer link that came to varying conclusions, including finding no link at all to finding an association for women but not for men.

Speaking on behalf of the American Beverage Association, consultant Richard H. Adamson said, "The study is, in my opinion, a weak study." Adamson, former vice president for science and technical affairs for the beverage association and, before that, a researcher at the National Cancer Institute, says that the study was "very small with regard to number of cases" of pancreatic cancer for major conclusions to be drawn from its data.

Further, Adamson says, the researchers didn't correct for other known pancreatic-cancer risk factors such as chronic pancreatitis, high-fat diet, workplace exposure to chemicals or gender (males are much more likely to get this cancer than females). The fact that the association didn't hold for juice raises questions, he said, as the sucrose in Singapore soft drinks "breaks down into the same thing that's in juice."

In the end, Adamson said, "The study doesn't scare me. I continue to drink soft drinks."

I'm not a soda drinker, and this study doesn't inspire me to start sipping. But while many public-health advocates believe we'd all be better off without soda in our lives, I'm not sure that if I did enjoy soda I'd stop drinking on the basis of this study alone. Because pancreatic cancer is relatively rare, even doubling your risk leaves your individual risk pretty low.

On the other hand, given the grim prospects for surviving pancreatic cancer (fewer than 5 percent of those diagnosed are alive after five years), and that fact that there's no screening test and very few treatment options, anything we can do to reduce our risk might be worth considering.

How about you? Are you a soda drinker? Does this study make you inclined to cut back?

For more health news, please follow me on Twitter!

By Jennifer LaRue Huget  |  February 8, 2010; 12:05 AM ET
Categories:  Cancer , Nutrition and Fitness  
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I think this study does not offer much evidence for a link between soda and pancreatic cancer. However, that does not change the linkage between sweetened pop and diabetes, which is a much bigger cause of death. As a type 2 diabetic, I never drink sweetened pop. Unfortunately, I'm a frequent drinker of Diet Coke, which has lots of aspartame.

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Posted by: jimpurdy | February 8, 2010 4:42 AM | Report abuse

This is a ridiculously small study to try to posit any cause-and-effect link between soda and pancreatic ca. Further, the authors' postulated biologic mechanism (working through activation of insulin-related growth factor) is really a stretch. And why would sugary OJ not have a similar mechanism? This is another case of PC pseudo-science: sodas are now a disfavored product, so any stretching of adverse data can be justified. I too will not change my soda drinking habits. G. Ross MD/ACSH

Posted by: rossdoc | February 8, 2010 7:56 AM | Report abuse

Here's the follow up question, and the one that may show why there's a difference in fruit juices vs. soda. Were all the sodas tested made with cane sugar, or with high fructose corn syrup (hfcs)? If the sodas were made with hfcs, was there any testing done on soda made with cane sugar to see if there was any difference in the outcomes? When it says "sugar sweetened carbonated beverages" was it REALLY sugar, or was it beverages sweetened with hfcs, as nearly all sodas in the US are?

Posted by: OrganicGal1 | February 8, 2010 8:18 AM | Report abuse

I am curious have they broken down the individual ingredients in soda, juices and other substances that contain fructose and other sugars? how about an immunoglobulin response test and also pancreatoc cell mitosis testing to each sugar compound?

Posted by: chrisf826 | February 8, 2010 9:40 AM | Report abuse

Ok, so looking at this another way: according to the study, of 140 cases of pancreatic cancer:

18 involved people who drank the most soda (2+/wk -- not a lot by US standards)
12 involved people who drank a little soda (less than 2/wk)
110 involved people who drank no soda

From this, one could just as easily hypothesize that some amount of soda has a protective effect, and that the most dangerous option would be to drink no soda at all.

Now, I am assuming that that is an absurd conclusion, that there is more to it than this -- that, for ex., these absolute numbers are very different on a percentage-of-total-population basis, and that the confounding factors were different within these three groups. But neither the post nor the link to the Singapore Chinese Health Study above gives any of that -- we get the headline in the post, and then the "supporting documentation" in the study just provides a very big-picture view of the study (which goes far beyond just the pancreatic cancer issue).

So, I guess I'm just supposed to take these guys at their word that they are drawing the right conclusions from the available data? Sorry, no dice -- you want a big, splashy, "double your risk" headline, you better back it up with some data showing how you got there.

Posted by: laura33 | February 8, 2010 10:54 AM | Report abuse

I think the problem here is the pressure to report. After working on a large project for several years with generous funding, one has to say something. To say that nothing was found, seem to no longer be acceptable. No wonder people are confused - epidemiologists are supposed help clarify or at least shed light on the relationship between food an health and not confuse us. This paper unfortunately belongs in the latter category.

Posted by: peterso | February 8, 2010 11:49 AM | Report abuse

Sodas are a disfavored beverage because they contain anywhere from 35-45 grams of sugar per 12 ounces without providing any nutritional benefit other than empty calories and are one of the causes of the diabetes epidemic that is destroying lives and will soon cause such a strain on our healthcare system that few will be able to afford the care that they need, whether there is healthcare reform or not.

That being said, this sample size is very small and the data that are given do not seem to bear out their conclusion. Are they using the same math that was used to figure credit default swaps on subprime mortgages? This apparently bogus conclusion draws attention away from the real dangers of soda and other sugary drinks.

I also will not change my soft drink/sugary drink habits, they will remain at 0 per week. Adamson probably doesn't drink the stuff his employers sell either, he just won't tell you that.

Posted by: Pragmaesthetic | February 8, 2010 12:05 PM | Report abuse

Major missing piece of information in the article:

How many in the sample drank >2,

If, say, half the sample drank none, then the study indicate that soda actually protects you from cancer.

If 90% drank none, then soda would seem to increase the incidence of cancer.

Without that info, the other numbers are meaningless. Please clarify.

Posted by: msh41 | February 8, 2010 12:05 PM | Report abuse

Correction to last post (line got truncated by less-than sign)

How many in sample drank more than 2, less than 2 and none?

Without that info, the other numbers are meaningless.

Posted by: msh41 | February 8, 2010 12:08 PM | Report abuse

Americans would be wise to open the tops of their soda cans and carefully dump them down the drain:1)save a huge amount of wasted money because there id no nutrition in it. Replace it with free water and lose weight 2) It may contribute to cancer. Who wants to take a chance? 3) Carbonated drinks can remove rust from a bolt. Any mechanic will tell you this. It is not doing your insides any good. My family ran a soda fountain in Indiana and many of the people who drank sodas all the time got stomach cancers. We didn't drink it.

Posted by: ay00 | February 8, 2010 2:01 PM | Report abuse

It is the high fructose corn syrup, and it not only causes this kind of cancer but responsible for type two diabetes among other diseases and yet the CDC, FDA, USDA and all others twiddle their thumbs.

Posted by: winemaster2 | February 8, 2010 4:46 PM | Report abuse

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