Higher consumption of sugar-sweetened beverages is associated with an increased risk of endometrial cancer: a prospective cohort study of 92,777 women from the UK Biobank

Introduction: The association between three beverage types-sugar-sweetened, artificially sweetened, and natural juices-and the incidence of endometrial cancer (EC) in a large cohort of women, given that this association is not yet fully understood. Methods: We conducted a prospective, population-based cohort study using data from 92,777 women in the UK Biobank with a median follow-up of 13.3 years. Cox proportional hazards regression and substitution analyses were used to evaluate the associations. Results: During follow-up, 682 new cases of EC were recorded. Higher consumption of sugar-sweetened beverages (SSBs) was significantly associated with an increased EC risk (HR 1.29 for >1 unit/day vs. non-consumers, P for trend = 0.004), while no statistically significant associations were found for artificially sweetened beverages (ASBs) or natural juices. Replacing SSBs with ASBs or natural juices was associated with a 12 and 9% reduction in EC risk, respectively, and body mass index (BMI) was found to mediate 18.2% of the association. Conclusion: In conclusion, higher consumption of SSBs is linked to an increased risk of EC, and substituting these drinks may help reduce this risk, highlighting the role of dietary choices in EC prevention.