Regular consumption of sugar-sweetened beverages is associated with more than double the risk of developing gastric cancer, according to prospective cohort research published recently in Gastro Hep Advances. Investigating data from over 112,000 participants tracked through 2022, scientists found no parallel link between artificially sweetened beverages and stomach cancer incidence.
Daily Sugary Drinks Double Gastric Cancer Risk
- The Core Finding: Drinking one or more sugar-sweetened beverages daily more than doubles a person’s risk of developing gastric cancer compared to non-consumers.
- Artificial Sweeteners: Drinks containing low-calorie artificial sweeteners showed no association with gastric cancer risk in the study cohorts.
- Metabolic Factors: Researchers point to potential underlying drivers like insulin resistance, fructose processing, and weight gain rather than bacterial infection.
Harvard Medical School Study Tracks 112,284 Health Professionals Over Decades
To evaluate the relationship between beverage intake and gastrointestinal malignancies, first author Andrew T. Chan, MD, MPH, of Massachusetts General Hospital and Harvard Medical School, led a collaborative team utilizing two large-scale prospective cohorts. The investigation drew from the Nurses’ Health Study (NHS)—comprising female registered nurses enrolled beginning in 1976—and the Health Professionals Follow-Up Study (HPFS), which included male health professionals enrolled in 1986. Patient data tracking extended through June 2021 for the NHS cohort and January 2022 for the HPFS cohort.
The study defined sugar-sweetened beverages as carbonated beverages, punch, lemonade, and sports drinks, while artificially sweetened beverages encompassed low-calorie carbonated beverages. Out of 112,284 total participants—68,311 women and 42,973 men—researchers recorded 278 verified cases of gastric cancer. Investigators utilized Cox proportional hazards models adjusted for factors including diet, body mass index, smoking, alcohol use, and diabetes status.
The statistical analysis revealed that participants consuming at least one sugar-sweetened beverage daily faced a gastric cancer hazard ratio (HR) of 2.45 compared to those who never consumed them. When evaluated by gender, the NHS female group registered an HR of 3.04, while the HPFS male group recorded an HR of 1.99. Total fructose intake—the primary sweetener in sugar-sweetened beverages—showed a direct positive association with gastric cancer risk across the combined cohort at an HR of 1.61.
Differentiating Metabolic Pathways From Artificial Sweeteners
Despite persistent public health debates regarding the long-term safety of artificial sweeteners, the study found zero statistical correlation between artificially sweetened beverages and gastric cancer incidence across any intake category.
“That makes us think this potential link could be through metabolic dysfunction, through pathways we know sugar-sweetened beverages may operate through — like raising blood insulin and glucose levels,” Andrew T. Chan explained. “Some of these insulin pathways that link to risk of gastrointestinal cancer may be a particular reason for why we saw this association.”
Additional mechanistic hypotheses under evaluation include chronic systemic inflammation, steroid hormone imbalances, weight gain, and disruptions to the gut microbiome, known as dysbiosis.
To isolate microbial factors, investigators also evaluated the prevalence of Helicobacter pylori, a bacterial pathogen linked to gastric carcinogenesis. Present in roughly one-third of the tested subset (36.7% in NHS and 34.0% in HPFS), H pylori infection rates showed no statistical association with the consumption of either regular sugar-sweetened or artificially sweetened beverages. This decoupling indicates that the elevated cancer risk is driven independently of bacterial colonization.
| Cohort Group | Participant Count | Gastric Cancer Cases | Daily Intake Hazard Ratio (HR) |
|---|---|---|---|
| Nurses’ Health Study (NHS) | 68,311 Women | 140 Cases | HR 3.04 (P for trend = .006) |
| Health Professionals Follow-Up Study (HPFS) | 42,973 Men | 138 Cases | HR 1.99 (P for trend = .035) |
| Total Combined Cohort | 112,284 Participants | 278 Cases | HR 2.45 (Daily vs. Never) |
Gastric Cancer Incidence Rises Among Younger Populations
The findings arrive as disease patterns change. Chan noted growing clinical concern over rising gastric cancer incidence rates among younger populations, a demographic shift potentially tied to increases in metabolic disease in younger populations.
Prior medical literature has examined carbonated beverage consumption across various cancer sites with mixed resolution. For instance, a meta-analysis published in the European Journal of Cancer Prevention by Boyle et al. evaluated over 50 independent risk estimates and calculated a summary relative risk (SRR) of 1.03 across all cancer types combined, finding no significant standalone elevation for individual sites such as the pancreas, kidney, or esophagus. However, the current prospective study represents an advancement by isolating gastric cancer specifically against long-term, quantified sugar-sweetened beverage intake.
Author disclosures note professional relationships with pharmaceutical and diagnostic entities including Pfizer Inc., Boehringer Ingelheim, and Freenome Holdings.
Researchers Aim to Isolate Precise Molecular Pathways
As investigators continue analyzing multi-decade dietary datasets, future work will aim to isolate precise molecular pathways and differentiate the carcinogenic profiles of individual artificial sweetener formulations. Establishing whether targeted interventions against insulin resistance and obesity can mitigate gastrointestinal malignancy risks remains a primary objective for ongoing clinical research.
References
- Gweon TG, Ha J, Kim H, Du M, Song M, Chan AT. Association between sugar-sweetened and artificially sweetened beverage intake and gastric cancer incidence. Gastro Hep Advances. 2026. DOI:10.1016/j.gastha.2026.101097
- Thrift AP, Wenker TN, El-Serag HB. Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention. Nat Rev Clin Oncol. 2023;20(5):338-349. DOI:10.1038/s41571-023-00747-0
- Boyle P, Koechlin A, Autier P. Sweetened carbonated beverage consumption and cancer risk: meta-analysis and review. Eur J Cancer Prev. 2014;23(5):481-490.
Disclaimer: This article is intended for informational and educational purposes only and does not substitute for professional medical advice, diagnosis, or treatment.
