In this interesting study published in the prestigious journal JAMA Otolaryngology-Head & Neck Surgery, the authors observed that the consumption of sugary drinks, mostly sugar-sweetened soft drinks, increased the risk of oral cavity cancer four to five times in adult white women living in the United States. Alcohol and tobacco use are known to be important risk factors for this tumour site, but taking these factors into account, the magnitude of the associations remained stable.

The methodology and quality of the study are excellent and the data have been analysed in great detail. The most important limitations of the work are well described in the manuscript, highlighting the low number of cases as oral cancer is a rare cancer. In addition, like any observational study, there are limitations with precision and objectivity of the estimation of sugar-sweetened beverages. Finally, the results may not be generalisable to other populations that are not similar to the study population, so it is not possible to know what would happen in men, women of other races or women of new generations who ingest other consumption patterns - for example, who drink more of these soft drinks or who consume them in conjunction with unhealthy foods, such as ultra-processed foods and fast food. More studies are needed to confirm these associations and also to assess whether soft drinks with artificial sweeteners would be just as harmful, as many people substitute one for the other.

There is very little evidence on the consumption of sugary drinks and the risk of oral cavity cancer, but sugary drinks have also been shown to increase the risk of other gastrointestinal tumours. Thus, recommendations for primary prevention of cancer in general continue to advise limiting consumption of sugary drinks and substituting them with healthy drinks, mainly water, and to a lesser extent coffee, tea and herbal teas, but always without added sugars.