© 2004 European Society for Medical Oncology
Review |
Artificial sweeteners—do they bear a carcinogenic risk?
Department of Internal Medicine I of the University of Cologne, Cologne, Germany
* Correspondence to: Dr M. R. Weihrauch, Immunologisches Labor Haus 16, Uniklinik Koeln, Joseph-Stelzmann-Strasse 9, 50924 Koeln, Germany. Tel: +49-221-4784488; Fax: +49-221-4785912; Email: martin.weihrauch{at}uni-koeln.de
Artificial sweeteners are added to a wide variety of food, drinks, drugs and hygiene products. Since their introduction, the mass media have reported about potential cancer risks, which has contributed to undermine the public's sense of security. It can be assumed that every citizen of Western countries uses artificial sweeteners, knowingly or not. A cancer-inducing activity of one of these substances would mean a health risk to an entire population. We performed several PubMed searches of the National Library of Medicine for articles in English about artificial sweeteners. These articles included ‘first generation’ sweeteners such as saccharin, cyclamate and aspartame, as well as ‘new generation’ sweeteners such as acesulfame-K, sucralose, alitame and neotame. Epidemiological studies in humans did not find the bladder cancer-inducing effects of saccharin and cyclamate that had been reported from animal studies in rats. Despite some rather unscientific assumptions, there is no evidence that aspartame is carcinogenic. Case–control studies showed an elevated relative risk of 1.3 for heavy artificial sweetener use (no specific substances specified) of >1.7 g/day. For new generation sweeteners, it is too early to establish any epidemiological evidence about possible carcinogenic risks. As many artificial sweeteners are combined in today's products, the carcinogenic risk of a single substance is difficult to assess. However, according to the current literature, the possible risk of artificial sweeteners to induce cancer seems to be negligible.
Key words: aspartame, cancer, cyclamate, saccharin, sweeteners
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