High fasting plasma glucose and the burden of colon and rectum cancer in China trends mortality and disability from 1990 to 2021

Background The burden of colon and rectum cancer (CRC) attributable to high fasting plasma glucose (HFPG) in China has been increasing, reflecting a significant public health challenge. Understanding the temporal trends and contributing factors to this burden is crucial for effective prevention and intervention strategies. Methods Data were extracted from the Global Burden of Disease (GBD) Study for the period between 1990 and 2021. Age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were analyzed using joinpoint regression to identify significant changes over time. The analysis also included a decomposition of the factors contributing to the increase in CRC deaths, including aging, epidemiological changes, and population growth. Results In 2021, the burden of CRC attributable to HFPG in China was substantial, with 18,440 deaths, predominantly among males. Males had higher age-standardized rates across all outcomes, with an ASMR of 1.26 per 100,000 compared to 0.62 per 100,000 in females. The joinpoint analysis revealed significant increases in ASMR, DALYs, and YLLs during the late 1990s and early 2000s, particularly among males. A significant rise in YLDs was observed, indicating an increasing burden of chronic disability. Comparatively, global trends mirrored those in China, with slight increases in ASMR, DALYs, and YLLs, but a more pronounced global rise in YLDs. Decomposition analysis showed that aging was the primary driver of the increase in CRC deaths, particularly among males, while epidemiological changes contributed to reduced mortality in females. Conclusions The burden of CRC attributable to HFPG in China has risen significantly over the past three decades, driven primarily by aging and, to a lesser extent, epidemiological changes and population growth. These findings highlight the need for targeted interventions to address the growing impact of HFPG on CRC outcomes, particularly the increasing chronic disability burden.