The association between artificial sweetener (AS) consumption and the risk of organ-specific cancers has been debated for decades. We hypothesized that AS consumption is associated with reduced risk of gastrointestinal (GI) cancers. We aimed to test this hypothesis by conducting a systematic review and meta-analysis of the association between AS and GI cancers. We searched 4 databases for comparative studies of AS consumption (exposed) versus no consumption (nonexposed) and the odds or risk of GI luminal or non–luminal cancer (primary outcome). Estimates were pooled using a random-effects model. Studies were evaluated for quality, bias, and heterogeneity. We analyzed 8 (4 prospective, 4 case-control) studies comprising data on 1,043,496 individuals, among whom 3271 pancreatic, 395 gastric, 304 esophageal, 3008 colorectal, and 598 oropharyngeal cancers occurred. While there was no significant association between AS consumption and odds of GI cancer overall, AS consumption was associated with 19% reduced likelihood of luminal GI cancer (OR 0.81, 95% CI:0.68-0.97). There was no association between AS consumption and non–luminal GI cancer. Meta-regression demonstrated no difference in effect estimates based on study type. Based on this first meta-analysis of AS and GI cancer, we demonstrated that AS consumption is associated with a significantly lower likelihood of luminal, but not non–luminal, GI cancer.

几十年来，人工甜味剂 (AS) 摄入量与器官特异性癌症风险之间的关系一直存在争议。我们假设食用 AS 与降低胃肠道 (GI) 癌症的风险有关。我们旨在通过对 AS 和胃肠道癌症之间的关联进行系统回顾和荟萃分析来检验这一假设。我们检索了 4 个数据库，对食用 AS（暴露）与不食用（未暴露）以及胃肠道管腔或非管腔癌症（主要结果）的几率或风险进行比较研究。使用随机效应模型汇总估计值。研究评估了质量、偏倚和异质性。我们分析了 8 项研究（4 项前瞻性研究，4 项病例对照研究），包含 1,043,496 名个体的数据，其中 3271 名胰腺癌、395 名胃癌、304 名食管癌、3008 名结直肠癌和 598 名口咽癌发生。虽然总体而言，AS 摄入量与胃肠道癌症发生率之间没有显着相关性，但 AS 摄入量与腔内胃肠道癌症可能性降低 19% 相关（OR 0.81，95% CI：0.68-0.97）。食用 AS 与非管腔胃肠道癌症之间没有关联。元回归表明，基于研究类型的效果估计没有差异。基于对 AS 和胃肠道癌症的首次荟萃分析，我们证明，食用 AS 与管腔胃肠道癌症而非非管腔胃肠道癌症的可能性显着降低相关。