Rising global burden of cancer attributable to metabolic risks from 1990 to 2021: Insights from the Global Burden of Disease Study 2021

Background The substantial rise in cancer burden driven by metabolic factors has become an urgent global health concern. This study aims to provide current estimates and analyze temporal changes in cancers attributed to metabolic risks. Methods Data concerning the global burden of metabolism-attributed cancers (MACs) were sourced from the Global Burden of Disease (GBD) 2021 dataset. We extracted data on estimated cancer-related deaths and disability-adjusted life years (DALYs) linked to metabolic risks from the GBD 2021 database, categorizing them by metabolic factor, sex, age, and socio-demographic index (SDI). Trends in age-standardized DALY rates (ASDR) over time were assessed using estimated annual percentage changes (EAPC). Results In 2021, the global DALYs attributed to MACs were approximately 15.58 million (95% uncertainty interval [UI]: 44.31 to 27.15 million), corresponding to an ASDR of 179.36 (95% UI: 51.23 to 312.41) per 100,000 person-years. Over the past three decades, there was a significant global increase in ASDR for cancers linked to metabolic risks (EAPC: 0.55, 95% confidence interval [CI]: 0.51 to 0.59). Although males had a higher cancer burden than females, females experienced a relatively greater increase in ASDR (EAPC: males 0.79 vs. females 0.36). The proportion of DALYs attributable to MACs rose progressively with advancing age, surpassing 89% in populations older than 50 years. Regionally, the cancer burden related to metabolic risks remained notably higher in high and high-middle SDI regions compared to lower SDI regions during the study period. However, lower SDI regions exhibited a markedly faster growth rate (EAPC across SDI levels from high to low: 0.20, 0.53, 1.44, 2.45, and 1.36, respectively). Central Europe had the highest ASDR due to MACs (357.87, 95% UI: 106.55 to 620.39 per 100,000 person-years), while the fastest increase occurred in Southern Sub-Saharan Africa (EAPC: 2.55, 95% CI: 2.22 to 2.88). Colon and rectum cancer in males and breast cancer in females were the predominant contributors to metabolism-related ASDR. Conclusion The rising global burden of cancers attributable to metabolic factors highlights inadequacies in existing prevention strategies. Immediate and sustained interventions are critically needed at both global and regional levels to manage metabolic risk factors effectively, aiming to reverse the current trends and mitigate the escalating burden of MACs.