Li Yuting, Hong Weiying, Chen Peiqing, Zhang Yu
Department of Interventional Endoscopy, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Front Oncol. 2025 Aug 26;15:1590382. doi: 10.3389/fonc.2025.1590382. eCollection 2025.
High fasting plasma glucose (HFPG) is an established risk factor for colorectal cancer (CRC). This study analyzes global epidemiological patterns and temporal trends of HFPG-attributable CRC burden from 1990 to 2021, with projections to 2040.
Using Global Burden of Disease 2021 data, we assessed geographical, sex-specific, age-related, and socio-demographic index (SDI) variations in mortality and disability-adjusted life years (DALYs). Joinpoint regression analysis was employed to evaluate the trends and inflection points, and the Bayesian Age-Period-Cohort (BAPC) model was performed to project future burden.
In 2021, HFPG accounted for 82,421 CRC deaths (95% UI: 42,427-125,402) and 1,750,923 DALYs (95% UI: 900,573-2,657,995) globally - marking substantial increases since 1990. Age-standardized mortality rates (ASMR) and DALY rates (ASDR) showed modest increases during 1990-2021 with an AAPCs of 0.31, but significant decline were identified post-2019, particularly in ASMR (APC = -0.94, < 0.05). Regionally, the highest burden were noted in high SDI region, Central Europe, Barbados, and Hungary, with China contributing the absolute numbers of CRC deaths and DALYs. The burden was more pronounced among males and the elderly, with a notable emerging trend of rapidly burden increasing among young males, especially in the 30-34 age group. Projections suggest continued declines in global ASMR and ASDR through 2040.
Despite global increases in HFPG-attributable CRC burden since 1990, recent declining trends (2019 onward) suggest potential progress in burden mitigation. Considering COVID-19 pandemic impacts on healthcare systems, post-2019 trends require cautious interpretation. Further longitudinal studies are essential to validate these trends. Given the significant variations across gender, age, and SDI, targeted interventional strategies should be developed and implemented to effectively manage this disease burden.
空腹血糖升高（HFPG）是结直肠癌（CRC）的既定危险因素。本研究分析了1990年至2021年HFPG所致CRC负担的全球流行病学模式和时间趋势，并预测至2040年。
利用2021年全球疾病负担数据，我们评估了死亡率和伤残调整生命年（DALY）在地理、性别、年龄以及社会人口学指数（SDI）方面的差异。采用Joinpoint回归分析评估趋势和拐点，并运用贝叶斯年龄-时期-队列（BAPC）模型预测未来负担。
2021年，HFPG在全球导致82421例CRC死亡（95%不确定区间：42427 - 125402）和1750923个DALY（95%不确定区间：900573 - 2657995），自1990年以来显著增加。年龄标准化死亡率（ASMR）和DALY率（ASDR）在1990 - 2021年期间略有上升，年龄-时期-队列百分比变化（AAPC）为0.31，但在2019年后出现显著下降，尤其是ASMR（APC = -0.94，P < 0.05）。在地区层面，高SDI地区、中欧、巴巴多斯和匈牙利的负担最高，中国的CRC死亡和DALY绝对数贡献较大。负担在男性和老年人中更为明显，年轻男性尤其是30 - 34岁年龄组中负担迅速增加的趋势显著显现。预测表明，到2040年全球ASMR和ASDR将持续下降。
尽管自1990年以来HFPG所致CRC负担在全球范围内有所增加，但近期（20
