ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1633508
Global, regional, and national burden of hyperglycemia-associated colorectal cancer, 1990-2021: a systemic analysis for the Global Burden of Disease Study
Provisionally accepted
- 1Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China
- 2The First Clinical College of Medicine, Fujian Medical University, Fuzhou, China
- 3Fujian Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fuzhou, China
- 4Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Background: Colorectal cancer (CRC) is a leading gastrointestinal malignancy with rising incidence. Hyperglycemia emerges as a critical driver of CRC progression, yet its global disease burden, particularly regarding health inequality and years lived with disability (YLDs), remains underexplored. Methods: This study leverages the Global Burden of Disease (GBD) 2021 dataset to analyze hyperglycemia-associated CRC burden across 21 regions and 204 countries from 1990 to 2021. It incorporates deaths, disability-adjusted life years (DALYs), YLDs, and years of life lost (YLLs), employing hierarchical clustering and health inequality metrics like the slope index of inequality and concentration index. Projections for 2022–2040 are generated using age-period-cohort models. Results: Globally, age-standardized rates (ASRs) of deaths, YLDs, YLLs, and DALYs attributed to hyperglycemia-associated CRC showed upward trends from 1990 to 2021, with YLDs exhibiting the highest consistent increase (EAPC=1.47, 95% UI:1.35–1.60). Significant health disparities persisted across the 30 years, with higher burdens concentrated in high-socio-demographic index (SDI) regions. Notably, while mortality-related burdens slightly decreased in high-SDI areas, YLDs continued to rise, indicating unmitigated disability burdens. Projections suggest stable death rates but increasing YLDs, DALYs, and YLLs through 2040. Conclusion: Hyperglycemia-associated CRC imposes an escalating global burden, marked by persistent health inequalities and rising long-term disabilities. Urgent strategies to enhance glycemic control, expand CRC screening, and address cross-national disparities are imperative to alleviate this burden.
Keywords: colorectal cancer, Hyperglycemia, GBD, 2021, health inequality
Received: 23 Jul 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Liu, Wei, Xu and Li. 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:
Yijuan Liu, liuyijuan0611@163.com
Ye Xu, sheerxu@126.com
Dan Li, doctorlidan99@fjmu.edu.cn
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