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Prevention of Non Communicable Diseases

Sugary drink consumption and the subsequent risk of gastric cancer: The Japan Public Health Center-based Prospective Study



Evidence on the association between sugary drink consumption and gastric cancer (GC) risk is limited, especially in Asian populations. This study aimed to investigate the association between consumption of sugary drinks (sugar-sweetened beverages and 100% fruit juices) and GC risk in a Japanese population.


This study included 74,455 Japanese individuals aged 45–74 years (35,102 males and 39,353 females) who participated in a population-based cohort study (Japan Public Health Center-based Prospective Study). Sugary drinks were assessed using a food frequency questionnaire. Cox proportional hazard regression was used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of GC incidence according to the quintile of sugary drink consumption.


We identified 2141 patients with GC cases during 16.7 years of follow-up. Sugary drink consumption was not associated with GC risk. The multivariate HR of total, cardia, and non-cardia GC in the highest vs. lowest quintile of sugary drinks consumption in males was 0.98 (95% CI: 0.82–1.17; p-trend 0.48), 0.48 (95% CI: 0.23–0.99; p-trend 0.03), and 1.03 (95% CI: 0.86–1.24; p-trend 0.88), respectively. In females, the respective multivariate HRs were 1.03 (95% CI: 0.79–1.33; p-trend 0.47), 1.28 (95% CI: 0.32–5.12; p-trend 0.53), and 1.01 (95% CI: 0.78–1.32; p-trend 0.56). The results did not change significantly after adjusting for Helicobacter pylori infection and atrophic gastritis status in the subgroup analysis.


In this Japanese prospective cohort study, sugary drink consumption was not associated with GC risk.

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Fig. 1: Flow chart of study participants (q05): JPHC Study.

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Program codes used for statistical analyses are available from the authors upon reasonable request.


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JPHC members are listed on the following website as of April 2020: We are indebted to the Aomori, Akita, Iwate, Ibaraki, Niigata, Osaka, Kochi, Nagasaki, and Okinawa Cancer Registries for providing incidence data. Author P.K thank the Ministry of Education, Culture, Sports, Science, and Technology of Japan (MEXT) for the scholarship for the Ph.D. program at Osaka University, Japan.


This study was supported by the National Cancer Center Research and Development Fund (since 2011) [23-A-31(toku), 26-A-2 and 29-A-4], Grant-in-Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan (from 1989 to 2010; 19shi-2) and the Ministry of Agriculture, Fishery and Forestry, Japan (JPJ005336). NS and ST received all grants listed.

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Authors and Affiliations



PK, TS, HI, and ESE designed the study. NS, MI, and ST performed the follow-up survey and collected data. PK performed statistical analysis of the data and wrote the original draft. PK, TS, HI, and ESE were involved in the interpretation of the data. All authors critically revised the paper for important intellectual content. All authors have read and approved the final paper.

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Correspondence to Tomotaka Sobue.

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The authors declare no competing interests.

Ethics approval

The study protocol was approved by the institutional review board of the National Cancer Center, Tokyo, Japan and by the Ethical Review Board of Osaka University, Osaka, Japan. The study was conducted in compliance with the provisions of the Declaration of Helsinki.

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All participants were informed of the objectives of the study and that completion of the survey questionnaire was regarded as providing informed consent.

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Khairan, P., Sobue, T., Eshak, E.S. et al. Sugary drink consumption and the subsequent risk of gastric cancer: The Japan Public Health Center-based Prospective Study. Eur J Clin Nutr (2022).

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