What Factors Contribute to This Increase?

The primary culprits behind the escalation of colorectal cancer among Millennials and Gen Xers appear to be lifestyle-related risk factors. While a family history of colon cancer and various chronic conditions of the large intestine are significant, other crucial contributors include poor dietary habits, obesity, smoking, alcohol consumption, and insufficient physical activity. As the prevalence of fast food consumption, obesity, and sedentary lifestyles rises, so too does the risk of developing colon cancer.

A recent study published in the journal Gut investigates the leading source of added sugars in the American diet—sugary beverages—and their association with early-onset colon cancer. Researchers examined data from nearly 120,000 women participating in the Nurses’ Health Study II from 1991 to 2015, with a follow-up period of 24 years. Among this substantial cohort, there were 109 documented cases of early-onset colon cancer (diagnosed before age 50).

Women who consumed higher amounts of sugary drinks tended to be less active and had poorer diet quality, characterized by lower consumption of fruits, vegetables, and fiber, alongside higher intake of processed meats. Even after controlling for these factors, as well as obesity and alcohol consumption, a greater intake of sugary beverages was linked to an increased risk of early colon cancer. Specifically, women who drank more than two servings of sugary drinks daily more than doubled their risk of developing colon cancer at a young age, with an additional risk associated with every extra sugary beverage consumed. Notably, this risk was tied to sugary drinks rather than fruit juices.

The Role of Sugary Drinks in Health Risks

In the latter half of the 20th century, sugary drink consumption among Americans surged, with children starting to consume sodas at younger ages and in larger quantities. It is well-established that sugary drinks are linked to obesity and several chronic diseases, including type 2 diabetes and heart disease. This study adds to the body of evidence suggesting a connection between sugary beverages and early-onset colon cancer within a large cohort of women.

But how might sugary drinks contribute to this increased risk? These beverages can lead to weight gain since they are calorie-dense yet do not provide a sense of fullness, potentially resulting in overeating. Additionally, they can spike blood sugar levels, causing increased insulin production, which over time may lead to insulin resistance, inflammation, type 2 diabetes, and weight gain—factors all recognized as risk contributors for colon cancer.

Furthermore, the authors of the study elaborate on how fructose, a common component of many added sugars, can disrupt gut health. The study notes:

“By causing dysbiosis and endotoxaemia, fructose can impair gut barrier function and increase gut permeability, which could promote colorectal carcinogenesis.” A recent experimental study found that mice treated with high fructose corn syrup exhibited significant colon tumor growth, independent of obesity or metabolic syndrome, reinforcing the connection between sugar-sweetened beverages and colorectal cancer risk.

To clarify, fructose is a major part of many added sugars, including table sugar and high fructose corn syrup. When consumed in sugary drinks, fructose can exceed the small intestine's absorption capacity, spilling over into the large intestine where it disrupts the balance of gut microorganisms (the microbiome) and generates harmful bacterial substances. This imbalance can foster changes in the gut that may promote the development of cancer cells.

Despite the rising rates of colon cancer among young individuals, it's important to note that the condition remains relatively rare. However, the more common health issues linked to sugary drinks—such as hypertension, type 2 diabetes, and heart disease—are well-documented and pose significant health risks.

This video, "Connect the Dots: Sugary drinks could cause colon cancer," delves into the connection between sugary beverages and the increasing rates of colorectal cancer among younger populations.

In this video, "Sugar & Colon Cancer | Connect the Dots," additional insights are provided on the impact of sugar consumption on colon cancer risks.

Dr. Ayala