Table 4.
Cumulative average of post-diagnostic energy-adjusted dietary sugar intake in relation to breast cancer-specific mortality after breast cancer diagnosis, stratified by insulin receptor status (n = 2,501 women, n=392 breast cancer deaths) and estrogen receptor status (n=8,384 women, n=982 breast cancer deaths), Nurses’ Health Study and Nurses’ Health Study II
| Quintile | Median of intake (grams) |
IR Status | ER Status | ||||||
|---|---|---|---|---|---|---|---|---|---|
| No. of deaths | IR positive | No. of deaths | IR negative | No. of deaths | ER positive | No. of deaths | ER negative | ||
| Total sugar | |||||||||
| 1 | 67.2 | 41 | 1 | 43 | 1 | 157 | 1 | 37 | 1 |
| 2 | 84.8 | 29 | 0.90 (0.55-1.47) | 37 | 0.81 (0.51-1.29) | 126 | 0.89 (0.70-1.13) | 33 | 0.95 (0.58-1.54) |
| 3 | 97.4 | 30 | 0.86 (0.52-1.42) | 39 | 0.87 (0.55-1.38) | 146 | 1.07 (0.85-1.35) | 39 | 0.96 (0.60-1.55) |
| 4 | 111.1 | 41 | 1.10 (0.69-1.76) | 53 | 1.32 (0.85-2.06) | 169 | 1.15 (0.91-1.44) | 50 | 1.28 (0.81-2.02) |
| 5 | 132.7 | 36 | 0.72 (0.43-1.20) | 43 | 1.22 (0.76-1.94) | 171 | 1.10 (0.87-1.39) | 54 | 1.40 (0.89-2.22) |
| P trend | 0.38 | 0.11 | 0.14 | 0.05 | |||||
| P Interaction | 0.03 | 0.11 | |||||||
| Added sugar | |||||||||
| 1 | 20.1 | 38 | 1 | 42 | 1 | 163 | 1 | 33 | 1 |
| 2 | 30.1 | 35 | 1.05 (0.65-1.69) | 55 | 1.24 (0.81-1.89) | 152 | 0.97 (0.77-1.21) | 32 | 0.99 (0.60-1.64) |
| 3 | 38.2 | 36 | 1.07 (0.66-1.73) | 43 | 0.93 (0.60-1.46) | 147 | 1.03 (0.82-1.29) | 40 | 0.98 (0.60-1.59) |
| 4 | 47.6 | 43 | 1.27 (0.79-2.04) | 36 | 0.89 (0.55-1.43) | 148 | 1.08 (0.86-1.35) | 55 | 1.40 (0.89-2.21) |
| 5 | 66.8 | 25 | 0.60 (0.35-1.03) | 39 | 1.19 (0.73-1.92) | 159 | 1.06 (0.85-1.33) | 53 | 1.31 (0.83-2.08) |
| P trend | 0.10 | 0.90 | 0.43 | 0.09 | |||||
| P Interaction | 0.20 | 0.04 | |||||||
| Natural sugar | |||||||||
| 1 | 34.5 | 27 | 1 | 41 | 1 | 151 | 1 | 50 | 1 |
| 2 | 47.1 | 35 | 1.21 (0.72-2.03) | 34 | 0.77 (0.48-1.25) | 118 | 0.86 (0.68-1.10) | 38 | 0.85 (0.55-1.32) |
| 3 | 56.6 | 32 | 1.25 (0.73-2.14) | 43 | 0.87 (0.55-1.38) | 154 | 1.01 (0.80-1.28) | 35 | 0.89 (0.57-1.39) |
| 4 | 66.9 | 45 | 1.67 (1.00-2.81) | 49 | 0.96 (0.62-1.49) | 172 | 1.17 (0.93-1.47) | 48 | 1.21 (0.79-1.84) |
| 5 | 83.3 | 38 | 0.97 (0.56-1.67) | 48 | 0.98 (0.62-1.56) | 174 | 0.97 (0.76-1.22) | 42 | 1.00 (0.64-1.56) |
| P trend | 0.97 | 0.73 | 0.61 | 0.56 | |||||
| P Interaction | 0.47 | 0.83 | |||||||
| Sucrose | |||||||||
| 1 | 22.9 | 42 | 1 | 39 | 1 | 154 | 1 | 30 | 1 |
| 2 | 30.8 | 32 | 0.89 (0.55-1.43) | 48 | 1.14 (0.73-1.78) | 161 | 1.02 (0.81-1.28) | 36 | 1.39 (0.84-2.29) |
| 3 | 36.9 | 40 | 1.22 (0.77-1.94) | 45 | 1.11 (0.71-1.75) | 141 | 1.06 (0.84-1.34) | 40 | 1.10 (0.67-1.81) |
| 4 | 43.6 | 28 | 0.72 (0.43-1.20) | 42 | 1.04 (0.65-1.66) | 142 | 1.05 (0.83-1.33) | 61 | 1.68 (1.05-2.68) |
| 5 | 56.1 | 35 | 0.80 (0.49-1.30) | 41 | 1.02 (0.63-1.66) | 171 | 1.15 (0.92-1.45) | 46 | 1.31 (0.80-2.14) |
| P trend | 0.25 | 0.90 | 0.20 | 0.24 | |||||
| P Interaction | 0.33 | 0.17 | |||||||
| Fructose | |||||||||
| 1 | 13.0 | 31 | 1 | 35 | 1 | 124 | 1 | 36 | 1 |
| 2 | 17.5 | 33 | 1.10 (0.65-1.84) | 43 | 1.33 (0.83-2.12) | 140 | 1.34 (1.04-1.71) | 39 | 1.22 (0.76-1.95) |
| 3 | 20.9 | 36 | 1.55 (0.93-2.58) | 38 | 1.31 (0.81-2.13) | 139 | 1.31 (1.02-1.68) | 47 | 1.51 (0.96-2.38) |
| 4 | 24.9 | 43 | 1.91 (1.16-3.14) | 45 | 1.28 (0.80-2.03) | 188 | 1.54 (1.22-1.95) | 40 | 1.55 (0.96-2.50) |
| 5 | 32.0 | 34 | 0.80 (0.47-1.38) | 54 | 1.73 (1.09-2.74) | 178 | 1.32 (1.04-1.68) | 51 | 1.38 (0.88-2.16) |
| P trend | 0.62 | 0.03 | 0.03 | 0.17 | |||||
| P Interaction | 0.03 | 0.68 | |||||||
Models were stratified by cohort and adjusted for age at diagnosis (year), calendar year of diagnosis, time between diagnosis and first FFQ (year), calendar year at start of follow-up of each-2-year questionnaire cycle, pre-diagnostic BMI (<18.5, 18.5 to <25.0, 25.0 to <30, 30 to <35, ≥35 kg/m2, missing), BMI change after diagnosis [no change (≥−0.5 to ≤0.5 kg/m2), decrease (<−0.5 kg/m2), increase (>0.5-2 kg/m2), increase (>2 kg/m2), missing], post-diagnostic smoking (never, past, current 1-14 cigarettes/day, current 15-24 cigarettes/day, current ≥25 cigarettes/day, missing), post-diagnostic physical activity (<5, 5 to <11.5, 11.5 to <22, ≥22 MET-h/week, missing), oral contraceptive use (ever, never), post-diagnostic alcohol consumption (<0.15, 0.15 to <2.0, 2.0 to 7.5, ≥7.5 g/day), post-diagnostic total energy intake (quintiles, kcal/day), pre-diagnostic menopausal status, age at menopause, and postmenopausal hormone use status (premenopausal; postmenopausal, age at menopause<50 year, and never postmenopausal hormone use; postmenopausal, age at menopause<50 year, and past postmenopausal hormone use; postmenopausal, age at menopause<50 year, and current postmenopausal hormone use; postmenopausal, age at menopause≥50 year, and never postmenopausal hormone use; postmenopausal, age at menopause≥50 year, and past postmenopausal hormone use; postmenopausal, age at menopause≥50 year, and current postmenopausal hormone use; missing), post-diagnostic aspirin use (never, past, current, missing), race (non-Hispanic white, other), stage of disease (I, II, III), ER/PR status (ER/PR positive, ER positive and PR negative, ER/PR negative, missing), radiotherapy (yes, no, missing), chemotherapy (yes, no, missing), and hormonal treatment (yes, no, missing). In the ER status analysis, we did not adjust for ER/PR status.