TABLE 3.
HRs and 95% CIs of colon or rectal cancer according to quintiles of sugar intake.
| Quintiles of sugar intake a (% energy/day) | ||||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | p for trend | |
| Men | ||||||
| Colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 181/121,749 | 152/123,461 | 172/123,701 | 136/124,383 | 137/124,160 | |
| Multivariable‐adjusted c | 1.00 (reference) | 0.86 (0.69–1.08) | 1.00 (0.79–1.26) | 0.79 (0.61–1.02) | 0.83 (0.63–1.09) | 0.24 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 190/122,003 | 162/123,464 | 159/123,308 | 126/124,387 | 141/124,292 | |
| Multivariable‐adjusted c | 1.00 (reference) | 0.88 (0.71–1.10) | 0.89 (0.71–1.12) | 0.72 (0.56–0.92) | 0.84 (0.65–1.09) | 0.20 |
| Proximal colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 78/121,749 | 58/123,461 | 68/123,701 | 66/124,383 | 60/124,160 | |
| Multivariable‐adjusted c | 1.00 (reference) | 0.71 (0.49–1.01) | 0.83 (0.58–1.19) | 0.80 (0.55–1.17) | 0.75 (0.49–1.13) | 0.30 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 82/122,003 | 66/123,464 | 63/123,308 | 58/124,387 | 61/124,292 | |
| Multivariable‐adjusted c | 1.00 (reference) | 0.80 (0.57–1.12) | 0.79 (0.55–1.12) | 0.74 (0.51–1.07) | 0.81 (0.55–1.20) | 0.33 |
| Distal colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 94/121,749 | 91/123,461 | 93/123,701 | 63/124,383 | 72/124,160 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.04 (0.77–1.41) | 1.12 (0.81–1.53) | 0.77 (0.53–1.10) | 0.93 (0.64–1.36) | 0.57 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 99/122,003 | 90/123,464 | 87/123,308 | 60/124,387 | 77/124,292 | |
| Multivariable‐adjusted c | 1.00 (reference) | 0.97 (0.72–1.30) | 0.98 (0.72–1.33) | 0.69 (0.48–0.97) | 0.92 (0.64–1.30) | 0.54 |
| Rectal cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 97/121,749 | 95/123,461 | 91/123,701 | 90/124,383 | 75/124,160 | |
| Multivariable adjusted c | 1.00 (reference) | 1.09 (0.81–1.47) | 1.11 (0.81–1.52) | 1.14 (0.82–1.59) | 1.05 (0.73–1.52) | 0.73 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 94/122,003 | 102/123,464 | 97/123,308 | 79/124,387 | 76/124,292 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.19 (0.89–1.58) | 1.19 (0.88–1.62) | 1.02 (0.73–1.41) | 1.07 (0.75–1.52) | 0.96 |
| Women | ||||||
| Colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 122/148,921 | 142/150,452 | 150/149,870 | 122/150,458 | 111/150,042 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.24 (0.96–1.59) | 1.32 (1.01–1.72) | 1.09 (0.82–1.45) | 0.99 (0.73–1.35) | 0.63 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 129/148,631 | 140/149,252 | 132/150,744 | 124/150,222 | 122/150,894 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.16 (0.91–1.49) | 1.10 (0.85–1.42) | 1.04 (0.79–1.37) | 1.02 (0.76–1.36) | 0.84 |
| Proximal colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 73/148,921 | 95/150,452 | 91/149,870 | 73/150,458 | 69/150,042 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.30 (0.94–1.79) | 1.23 (0.87–1.72) | 0.96 (0.67–1.40) | 0.87 (0.58–1.29) | 0.12 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 78/148,631 | 95/149,252 | 82/150,744 | 70/150,222 | 76/150,894 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.24 (0.91–1.70) | 1.06 (0.76–1.47) | 0.89 (0.62–1.27) | 0.92 (0.63–1.34) | 0.19 |
| Distal colon cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 40/148,921 | 39/150,452 | 52/149,870 | 44/150,458 | 35/150,042 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.14 (0.72–1.80) | 1.61 (1.02–2.54) | 1.50 (0.92–2.44) | 1.27 (0.74–2.17) | 0.22 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 42/148,631 | 37/149,252 | 44/150,744 | 48/150,222 | 39/150,894 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.04 (0.66–1.63) | 1.28 (0.82–2.02) | 1.49 (0.94–2.36) | 1.28 (0.77–2.13) | 0.14 |
| Rectal cancer | ||||||
| Total sugars b | ||||||
| Number of cases/person‐years | 38/148,921 | 43/150,452 | 54/149,870 | 49/150,458 | 61/150,042 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.24 (0.79–1.95) | 1.57 (1.00–2.47) | 1.44 (0.89–2.32) | 1.75 (1.07–2.87) | 0.03 |
| Total fructose (fructose + ½ × sucrose) | ||||||
| Number of cases/person‐years | 40/148,631 | 41/149,252 | 56/150,744 | 46/150,222 | 62/150,894 | |
| Multivariable‐adjusted c | 1.00 (reference) | 1.07 (0.68–1.67) | 1.45 (0.94–2.24) | 1.18 (0.74–1.88) | 1.50 (0.94–2.40) | 0.10 |
Abbreviations: CI, confidence interval; CRC, colorectal cancer; HR, hazard ratio; PUFA, polyunsaturated fatty acid; SFA, saturated fatty acid.
a
Participants were categorized into quintiles of total sugar or total fructose intake by sex for the analyses of the corresponding sugar type.
b
“Total sugars” represent the sum of the consumption of the following saccharides: glucose, fructose, galactose, sucrose, maltose, and lactose.
c
Adjusted for age and public health center area, body mass index, alcohol consumption, smoking status, physical activity, family history of CRC, history of diabetes, CRC screening, postmenopausal status (women only), use of exogenous female hormones (women only), total energy intake, and intake of SFAs, n‐3 PUFAs, magnesium, vitamin D, vitamin B6, vitamin B12, calcium, dietary fiber, and folate.