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One Sugary Drink a Day Was Linked to Double the Risk of Stomach Cancer. Here's What the Study Found — and the Bigger Risk Factor Most Headlines Skipped

Writer: DobroMedOnline
DobroMedOnline
Sep 12
7 min read

You've probably seen the headline this week: one sugary drink a day, more than double the risk of stomach cancer. It came from a real study, from a serious research group, and the number is accurate. But a number like "2.45 times" tells you almost nothing on its own — and the most useful part of this story for our community isn't the soda at all.

Let's walk through what was actually found, what it can and can't prove, and why people who grew up in Ukraine, Russia, Moldova, or anywhere in Eastern Europe should read this a little differently than the average American.

What happened

On September 9, Mass General Brigham announced results from a study published in the journal Gastro Hep Advances. Researchers followed 112,284 U.S. adults from two of the longest-running health studies in the country — the Nurses' Health Study and the Health Professionals Follow-Up Study — for several decades. Every few years, participants reported in detail what they ate and drank.

Over that time, 278 of them developed gastric (stomach) cancer.

People who drank at least one sugar-sweetened beverage a day had a 2.45 times higher risk of gastric cancer than people who drank less than one a month. Among women, the association was stronger: more than one sugary drink a day was tied to roughly a threefold higher risk. Higher total fructose intake — fructose is the main sugar in these drinks — was also linked to more gastric cancer.

Diet drinks did not show the same pattern. After adjusting for other factors, artificially sweetened beverages were not associated with higher risk.

The senior author, gastroenterologist Andrew Chan, MD, MPH, called it the first study to show this association in a U.S. population. For a cancer that is the fifth leading cause of cancer death worldwide, that is a meaningful gap to fill.

How to read "2.45 times"

This is where headlines and reality part ways.

First, this is an observational study. It can show that two things travel together; it cannot prove one causes the other. The researchers said so themselves. People who drink soda every day often differ from people who never do — in weight, smoking, overall diet, income, and things no questionnaire captures. The statistical adjustments help, but they never fully close that gap.

Second, look at the absolute numbers. 278 cancers among 112,000 people over decades is a rare outcome. Doubling a small risk still produces a small risk. If your baseline lifetime chance of stomach cancer is under 1%, "2.45 times" moves you to a low single-digit percentage — real, worth acting on, but not a coin flip.

Third, the study population was mostly white health professionals. Whether the same pattern holds in other groups — including immigrants from high-incidence regions — is unknown.

Fourth, and this matters: the risk was concentrated at daily intake. People who drank sugary beverages weekly or monthly did not show a clear increase. This is a story about habit, not about the occasional soda at a birthday.

None of this makes the finding unimportant. Sugar-sweetened drinks have already been tied to higher rates of colorectal, breast, and liver cancer, and their links to type 2 diabetes, fatty liver, and weight gain are much better established. This study adds another reason to

a list that was already long. It just shouldn't be read as "soda causes stomach cancer."



The part the headlines skipped

Here's what most coverage left out, and it's the part that changes what you should actually do.

Stomach cancer is not evenly distributed around the world. It is most common in East Asia, the western coast of South America, and Eastern Europe. Historically, gastric cancer incidence in Ukraine, Russia, and neighboring countries has run well above U.S. rates — in Ukraine, official figures once exceeded 25 cases per 100,000 people per year, several times the U.S. rate.

The dominant reason is a bacterium: Helicobacter pylori (H. pylori). It infects the stomach lining, usually in childhood, often silently, and is the single most important known cause of gastric cancer. In Russia, a 2025 meta-analysis put the pooled adult prevalence at about 63% over the past three decades, with older cohorts closer to 75–80%. Comparable data for Ukraine are sparse, but the region is consistently grouped among the highest-prevalence areas in Europe. In the U.S., adult prevalence is far lower — and among people who grew up here, lower still.

If you spent your childhood in Eastern Europe, the odds that you carry H. pylori are high. That does not mean you will develop cancer — most infected people never do. But it means your baseline risk is not the baseline in this study, and it means there is a specific, testable, treatable factor in the picture.

Notably, the researchers checked whether H. pylori explained the soda finding. In the subset of about 940 participants with H. pylori data, roughly a third were infected, and there was no link between sugary-drink intake and infection. So the soda association appears to be separate from H. pylori — which means, for someone with both, the risks may stack rather than overlap.

What the guidelines say

Two current U.S. recommendations are directly relevant.

Screening. In its 2025 clinical practice update, the American Gastroenterological Association said that certain higher-risk groups in the United States should be considered for gastric cancer screening. The list includes first-generation immigrants from high-incidence regions, people with a first-degree relative who had gastric cancer, and people with certain hereditary cancer syndromes. The best screening tool is a high-quality upper endoscopy — a short outpatient procedure, done under sedation, that allows the specialist to look directly at the stomach lining and take biopsies if anything looks abnormal. This is not routine for the general U.S. population. It is a conversation worth having if you fit one of those groups.

Eradicating H. pylori. The AGA lists H. pylori eradication as the most important form of primary prevention. The American College of Gastroenterology's 2024 treatment guideline recommends that anyone who tests positive be treated, and that the first-line regimen for most patients be a 14-day "bismuth quadruple therapy" — a proton pump inhibitor, bismuth, tetracycline, and metronidazole. Older regimens built around clarithromycin (the "triple therapy" many patients from Eastern Europe remember) are no longer preferred because resistance is so common.

Testing is simple: a urea breath test or a stool antigen test. Both require being off acid-suppressing medications like omeprazole (Prilosec) or pantoprazole (Protonix) for at least two weeks beforehand and off antibiotics for four weeks, or the result can come back falsely negative. A blood antibody test is easy to order but can stay positive for years after the infection is gone, so it cannot confirm a cure.

One more step people often skip: after treatment, ACG recommends a test of cure — a repeat breath or stool test at least four weeks after finishing antibiotics — because treatment fails in a meaningful share of cases, especially with clarithromycin-based regimens. Feeling better is not proof the bacterium is gone.

What about kompot, sweet tea, and juice?

A fair question, because the American definition of "sugar-sweetened beverage" in this study — carbonated soft drinks, punch, lemonade, sports drinks — doesn't map neatly onto an Eastern European kitchen.

The study did not measure homemade kompot, sweetened tea, or fruit juice, so we can't say they carry the same association. What we can say is that the plausible mechanism the researchers point to is sugar and fructose load, not carbonation. A glass of kompot made with several spoons of sugar, tea with two or three sugars several times a day, or a daily glass of store-bought juice delivers a comparable amount of sugar to a can of soda. That's a reasonable inference, not a study finding — but it is a reasonable one.

Who should pay particular attention

Someone who grew up in Ukraine, Russia, Belarus, Moldova, the Baltics, Central Asia, or the Caucasus and has never been tested for H. pylori. Anyone with a parent, sibling, or child who had stomach cancer. Anyone with a previous diagnosis of atrophic gastritis or intestinal metaplasia on a biopsy. Anyone who was treated for H. pylori years ago but never had a test to confirm it worked. And, yes, anyone in those groups who also drinks a sugary beverage every day.

When to get evaluated

Early gastric cancer usually causes no symptoms at all, which is exactly why screening exists for high-risk groups. But some symptoms should prompt an evaluation rather than a wait-and-see approach: difficulty or pain when swallowing; unintended weight loss; persistent upper abdominal pain or fullness after small meals; vomiting, especially with blood; black, tarry stools; new iron-deficiency anemia without an obvious cause; or new, persistent indigestion in someone over 60. None of these means cancer — most turn out to be something else — but they are the symptoms that warrant an upper endoscopy rather than another month of antacids.

The practical takeaway

The soda finding is real but modest. The reasonable response is the one you'd have made anyway: if a sugar-sweetened drink is a daily habit, make it an occasional one. Water, unsweetened tea, or coffee are the obvious swaps, and the study gave no reason to fear diet drinks in this context.

The bigger opportunity, for our community specifically, is the one that didn't make the headline. A single breath or stool test can tell you whether you carry the bacterium responsible for most stomach cancers, and a two-week course of treatment can remove it. If you're a first-generation immigrant from a high-incidence region, a one-time upper endoscopy is a conversation worth having with your provider.

DobroMed Online provides telehealth primary and urgent care and can order H. pylori testing, review your risk factors, and refer you for endoscopy when appropriate. This article is educational and does not replace individual medical advice.

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