Background: The role of sweeteners on cancer risk has been widely debated over the last few decades. To provide additional information on saccharin and other artificial or low-calorie sweeteners (mainly aspartame), we updated the analysis of an integrated network of case-control studies conducted in Italy between 1991 and 2004 including data on cancers of the stomach, pancreas, andend ometrium. Patients and Methods: Cases were 230 patients with incident, histologically confirmed cancers of the stomach and 547 corresponding controls, 326 of the pancreas and 652 controls, and 454 of the endometrium and 908 controls. All controls were patients admitted to the same hospitals as cases for acute, non-neoplastic disorders. Odds ratios (OR) and corresponding confidence intervals (CI) were derived by unconditional logistic regression models. Results: After allowance for various confounding factors, ORs for ever users of sweeteners versus nonusers were 0.80 (95% CI, 0.45-1.43) for gastric cancer, 0.62 (95% CI, 0.37-1.04) for pancreatic cancer, and 0.9 6 (95% CI, 0.67-1.40) for endometrial cancer. Corresponding ORs for saccharin were 0.65, 0.19, and 0.71, andfor other sweeteners were 0.86, 1.16, and1.07, respectively, for the three cancer sites. Conclusions: The present study adds further evidence on the absence of an adverse effect of low-calorie sweetener (including aspartame) consumption on the risk of common neoplams in the Italian population.
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