A burden of proof study of the effects of exposure to high fasting plasma glucose on the risk of seven types of cancer

Abstract Cancer is a major public health problem strongly influenced by genetic factors and aging; however, a proportion of its burden can be attributed to potentially modifiable risk factors. We undertook a systematic review and meta-analysis of the existing evidence to quantify and assess the relationship between high fasting plasma glucose (FPG) levels and the risk of developing and dying for seven types of cancer (selected for having attributable burden from FPG in GBD). Using Burden of Proof methods that provide a conservative interpretation of the evidence, we found moderate relationships between high FPG and the risk of breast, pancreatic, and colorectal cancer. Weak relationships were observed with bladder, liver, ovarian, and tracheal, bronchus and lung cancers. These findings should galvanize the global community’s efforts in addressing the increasing burden of high blood sugar and inform the potential impact of different hypoglycemic treatments on reducing the burden of cancer.