Association between soft drink consumption types and risk of lung cancer and all-cancer: A prospective study of PLCO data

Dongfang You; Hongyang Xu; Xin Chen; Jiawei Zhou; Yaqian Wu; Yingdan Tang; Zhongtian Wang; Yang Zhao; Fang Shao

doi:10.7555/JBR.36.20220135

Association between soft drink consumption types and risk of lung cancer and all-cancer: A prospective study of PLCO data

J Biomed Res. 2022 Nov 20;36(6):390-400. doi: 10.7555/JBR.36.20220135.

Authors

Dongfang You¹, Hongyang Xu², Xin Chen¹, Jiawei Zhou¹, Yaqian Wu¹, Yingdan Tang¹, Zhongtian Wang¹, Yang Zhao^{1

3

4

5}, Fang Shao¹

Affiliations

¹ Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
² Department of Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China.
³ China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
⁴ The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
⁵ Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China.

Abstract

Diet/sugar-free soft drinks are considered to be healthier than regular soft drinks. However, few studies have examined the relationship between the types of soft drinks (regular and diet/sugar-free) and lung cancer (LC)/all-cancer (AC) risk. In this study, we comprehensively assessed the influence of the type of soft drink consumption on LC/AC risk based on the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Multivariable Cox proportional hazards and competing risks Fine-Gray regression models adjusted for relevant confounders were used to estimate hazard ratios (HRs) and subdistribution HRs for different types of soft drink consumption. In the PLCO population, female subgroup, and the ever/current smoker subgroup, consumption of both regular and diet soft drinks was associated with a significantly reduced risk of LC compared with no soft drinks at all. For the non-lung cancer (NLC) risk, consumption of only diet soft drinks had a significant positive association for the total population and female subgroup. Based on our findings, it was suggested that partial replacement of regular soft drinks with diet soft drinks might be beneficial to LC prevention, especially for females and ever/current smokers. Additionally, completely replacing regular soft drinks with diet soft drinks might be detrimental to NLC prevention, especially for females.

Keywords: PLCO trial; all-cancer; diet/sugar-free drink; lung cancer; soft drink.

Grants and funding

This work was supported by the National Natural Science Foundation of China (Projects No. 82173620 to Y.Z. and 82204156 to D.Y.) and Priority Academic Program Development of Jiangsu Higher Education Institution. The authors are also grateful to Mrs. Yue Wang for language polishing.