ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1683893
This article is part of the Research TopicCancer Epidemiology: Patterns, Causes, and Therapeutic AdvancementsView all 4 articles
Global burden, trends, and inequalities in cancer and subtypes attributable to high BMI among older adults, 1990-2021: a secondary analysis of the global burden of disease study 2021
Provisionally accepted
- 1Zhuji Maternal and Child Health Hospital, Zhuji, China
- 2Zhuji People's Hospital of Zhejiang Province, Zhuji, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: High body mass index (BMI) is a significant modifiable risk factor for cancer, yet its global burden in older adults (aged ≥60 years) remains incompletely understood. Methods: Using Global Burden of Disease Study 2021 data, we estimated disability-adjusted life-years (DALYs) and age-standardised DALY rates (ASDRs) for total and 11 high BMI-related cancers from 1990 to 2021. Trends were assessed using average annual percentage change. Inequalities were measured using the slope index of inequality and concentration index. Additionally, decomposition and frontier analyses were utilized to examine driving factors and explore improvement potential. Results: Global cancer-related DALYs attributable to high BMI in older adults increased from 2.11 million in 1990 to 5.40 million in 2021, with ASDR rising from 439.99 to 497.15 per 100,000 population. Males showed greater increases despite lower ASDR. From 1990 to 2021, Asia and Africa experienced the steepest increases, while Europe and America recorded the highest ASDRs in 2021. High Socio-demographic Index (SDI) regions consistently reported the highest ASDRs in both 1990 and 2021, whereas low-middle SDI regions exhibited the most rapid increase during this period. The global ASDRs for most cancers increased from 1990 to 2021, with colorectal cancer demonstrating the highest ASDR among men and breast cancer among women in 2021. DALY growth was largely attributed to population expansion (133.0%) through decomposition analysis. Inequalities have narrowed but remained predominantly concentrated in higher SDI countries. Frontier analysis identified several high SDI countries, such as the United Arab Emirates, Slovakia, and Qatar, with substantial potential for burden reduction. Conclusion: The cancer burden attributable to high BMI in older adults has risen substantially since 1990, with marked geographic, socioeconomic, and cancer-site disparities. Targeted high BMI reduction strategies in ageing populations are critical to mitigating future cancer burden and reducing inequalities.
Keywords: Global burden of disease, Cancer, Disability-adjusted life years, high body mass index, older adults, health inequalities, Joinpoint regression model
Received: 11 Aug 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Huang, Qiu and Xuan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Feng Xuan, xfeng8901@outlook.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.