Association between Artificial Sweetener-Aspartame Consumption and Colorectal Cancer Risk: Evidence-Based Strategies

In this study, clinical trials were generalized, summarized, and meta-analyzed to evaluate correlations between artificial sweeteners (ASs) and colorectal cancer (CRC). PubMed, Web of Science, Embase (Ovid platform), MEDLINE, and the Cochrane Library databases were searched from inception until July 24, 2023. The association between AS exposure and CRC incidence was assessed using odds ratios (ORs) and 95% confidence intervals (CIs). STATA software (version 12.0) was used to perform the meta-analysis. Ten studies (three case-control studies and seven cohort studies) involving 711,537 participants were identified. Results showed that the intake of ASs reduced the incidence of CRC (OR = 0.93, 95% CI = [0.87-0.99]) and was not significantly associated with mortality (OR = 0.93, 95% CI = [0.83-1.05]). Subgroup analyses showed that low doses of ASs were associated with lower CRC incidence (OR = 0.90, 95% CI = [0.83-0.99]), and medium/high doses were not associated with CRC incidence (OR = 1.11, 95% CI = [0.93-1.33]; OR = 0.89, 95% CI = [0.79-1.00], respectively). Moreover, low, medium, and high exposures were not associated with an increased risk of mortality due to CRC (OR = 0.95, 95% CI = [0.80-1.14]; OR = 0.99, 95% CI = [0.88-1.11]; OR = 0.93, 95% CI = [0.71-1.21], respectively). The results of our meta-analysis showed that a low intake of ASs may be associated with a lower risk of CRC.