Many have attempted to tackle the mystery behind the disease nicknamed âÄúthe silent killer.âÄù âÄúWhen it comes to pancreatic cancer, we donâÄôt have a clue,âÄù said Mark Pereira, associate professor of epidemiology at the University of Minnesota. âÄúBy the time you get diagnosed, youâÄôre basically starting to die. ThereâÄôs not much at all we can do.âÄù Pereira recently led a study that added itself to the growing list of attempts to explain the diseaseâÄôs mysterious causes. His conclusion: Soda may be to blame. The study followed more than 60,000 middle-aged and older Chinese men and women in Singapore for 14 years, keeping track of their age, diet, smoking habits, obesity, overall health and soft drink consumption. At the end of the study, those who drank high amounts of soda âÄî an average of five cans per week âÄî were found to be 87 percent more likely to develop pancreatic cancer. Although the percentage seems high, only 140 people were diagnosed. By contrast, about 6,000 people in the group drank more than two sodas a week and were considered âÄúhigh soda drinkers.âÄù That number is much smaller than other studies âÄî some of which have found the same link, Lou Harvin, spokesman for the American Cancer Society, said. âÄúItâÄôs similar to reports we have seen in the past,âÄù he said, âÄúso itâÄôs not shocking.âÄù Pancreatic cancer is the fourth most common cause of cancer-related deaths in the United States. The ACS estimates that one in 72 Americans will develop the cancer in their lifetime, with the odds being almost equal between men and women. In their study, the researchers did not account for diet sodas. It wouldnâÄôt have made sense to study diet sodas in this group, Pereira said, as more than 90 percent of the participants drank regular soda. The chemical makeup of the sugar in regular soda, mostly high-fructose corn syrup, is different than that of diet soda, Pereira said. âÄúThose different sugars donâÄôt exist in diet beverages,âÄù he said, âÄúso I donâÄôt really have any reason to believe diet beverages would increase the risk of pancreatic cancer.âÄù ThatâÄôs an important question that was left out, said Michelle Duff, director of research and scientific affairs for the Pancreatic Cancer Action Network, as so many Americans drink diet soda. âÄúYou immediately think, âÄòOh gosh, well I drink diet soda, does that count?âÄô âÄù she said. âÄúUnfortunately, we donâÄôt have the answer to that by this article.âÄù Drinking soda spurs a rise in blood sugar, which in turn causes the pancreas to secrete insulin to control it. Insulin stores nutrients and promotes growth, including the growth of tumor cells in the pancreas. The idea behind the study was to find a causal relationship between cancer and sugar intake, something people have control over and can change, Pereira said. âÄúIt sounds old, silly and trite, but the good thing about this study is it brings that up once again,âÄù Harvin said. âÄúItâÄôs just saying, âÄòPeople, think about what youâÄôre putting into your body, because itâÄôs going to have an impact on how well you live, how long you live and how healthy youâÄôll be.âÄô âÄù If the connection is simply sugar acting on the pancreas, then these results have implications for other sugar-laden foods, Pereira said, although that would take more research, and itâÄôs more difficult to measure eating habits than beverage consumption. The study did not find a significant connection between pancreatic cancer and juice for two reasons, Pereira said. First, juice contains naturally occurring sugar, which hasnâÄôt been shown to increase oneâÄôs blood sugar as much as soda. Second, itâÄôs sold in much smaller portion sizes. If juice came in larger portions, the results may have been different, he said. The more important public health concerns are diabetes, obesity and heart disease, because they affect so many more people, Pereira said. By the end of the study, 6,000 people had type 2 diabetes. Based on the results, it would be interesting to now explore a possible connection between diabetes and pancreatic cancer, Buss said. âÄúItâÄôs interesting to see whether we can determine if diabetes could be an early marker,âÄù she said, âÄúbecause we donâÄôt have early detection methods with this cancer.âÄù This is the first study of its kind performed on Asians. In previous studies trying to link soda to pancreatic cancer, two found a connection and two did not. Pereira said he wanted to find out whether the connection could apply to populations all over the world. The American Beverage Association released a statement rejecting the results, highlighting the fact that the National Cancer Institute does not include consumption of sugar-sweetened beverages as a risk factor for pancreatic cancer. âÄúThe fact remains that soft drinks do not cause cancer, nor do any authoritative bodies, such as NCI, name soft drinks as a risk factor for pancreatic cancer,âÄù the statement said. âÄúYou can be a healthy person and enjoy soft drinks.âÄù