Daily sugary drinks tied to gastric cancer risk

Clinical takeaway: For patients drinking sugary beverages daily, gastric cancer can be added to the reasons to cut back. Risk was not elevated at weekly or monthly intake, so occasional intake may not warrant the same concern. 

Gastric cancer is uncommon enough in US primary care that few clinicians carry a working model for preventing it. When a patient with a family history asks what to change, the answer has been thin: less salt-preserved and pickled food, stop smoking, test and treat infection if it turns up. Beyond that, dietary advice has been improvisation. 

New prospective data give that conversation one more concrete discussion point. Sugary drinks already carry a long list of metabolic reasons to drink fewer of them, and they also may raise gastric cancer risk among people drinking them every day. 

Adults drinking at least one 8 oz sugar-sweetened beverage daily had 2.45 times the risk of incident gastric cancer compared with those drinking fewer than one per month. Roughly two-thirds of American adults report doing so every day. Artificially sweetened beverages showed no association at any intake level. Higher total fructose intake tracked with incidence as well. 

The absolute numbers are small: about 16 gastric cancers per 100,000 person-years among daily drinkers versus 8 in the reference group. The association ran stronger in women than men, with roughly 3 times the risk versus 2 times. Risk did not rise across the monthly or weekly categories, so the elevation sat entirely at daily intake. In a subset of 940 participants with serology available, sugar-sweetened beverage intake showed no relationship to H. pylori status, so the signal does not appear to work by way of infection. 

The analysis pooled 112,284 adults from the Nurses' Health Study and Health Professionals Follow-up Study, following them from 1986 through 2021 and 2022 on food frequency questionnaires collected every four years. There were 278 gastric cancers across 3.2 million person-years. Adjustment was extensive, covering BMI, smoking, alcohol, diet quality, diabetes, and acid-suppression use. 

The H. pylori serology work rules out one obvious pathway, leaving weight gain, insulin resistance, inflammation, and dysbiosis as candidates that this study did not address. That matters less for counseling than for whether the association holds up, and confirmation in more diverse cohorts is what would help to unpack a potential mechanism. 

"This is the first study to demonstrate an association between sugar-sweetened beverage intake and gastric cancer in a U.S. population," said senior author Andrew Chan, MD, MPH, a gastroenterologist and epidemiologist with the Mass General Brigham Cancer Institute. "Gastric cancer is the fifth leading cause of cancer death worldwide, but we've known very little about how diet might contribute to this cancer." 

Source: Gweon TG, et al. (2026 Aug 17) Gastro Hep Adv. Association between sugar-sweetened and artificially sweetened beverage intake and gastric cancer incidence