{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:14:13Z","timestamp":1781770453953,"version":"3.54.5"},"reference-count":54,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Impaired fasting glucose (IFG) is associated with the risk of various cancers, but the cumulative effect of IFG on gastrointestinal cancer risk remains unclear. This study evaluated the association between the cumulative exposure to IFG and gastrointestinal cancer risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors extracted data from the Korean National Health Insurance Service and health examination data sets. Among individuals \u226540 years old who were free of diabetes or cancer, 1,430,054 who underwent national health examinations over 4 consecutive years from 2009 to 2012 were selected and followed up until gastrointestinal cancer diagnosis, death, or December 31, 2019. The IFG exposure score (range, 0\u20134) was based on the number of IFG diagnoses over 4\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up duration was 6.4\u00a0years. Consistent normoglycemia for 4\u00a0years was found in 44.3% of the population, whereas 5.0% had persistent IFG and 50.7% had intermittent IFG. Compared to the group with an IFG exposure score of 0, groups with IFG exposure scores of 1, 2, 3, and 4 had a 5%, 8%, 9%, and 12% increased risk of gastrointestinal cancer, respectively (score 1: adjusted hazard ratio [aHR], 1.05; 95% confidence interval [CI], 1.01\u20131.08; score 2: aHR, 1.08; 95% CI, 1.04\u20131.12; score 3: aHR, 1.09; 95% CI, 1.05\u20131.14; score 4: aHR, 1.12; 95% CI, 1.06\u20131.19). Persistent IFG exposure was also associated with higher risks of individual cancer types (colorectum, stomach, pancreas, biliary tract, and esophagus).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cumulative exposure to IFG is associated with an increased risk of developing gastrointestinal cancer, in a dose\u2010dependent manner.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Hyperglycemia, including both diabetes and prediabetes, has been associated with an increased risk of various cancers.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>However, the cumulative effect of impaired fasting glucose on the risk of developing gastrointestinal cancer remains unclear.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>A frequent diagnosis of impaired fasting glucose was dose\u2010dependently associated with a higher risk of developing overall gastrointestinal cancer.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Furthermore, risks of individual cancer types increased with persistent impaired fasting glucose.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Early detection of hyperglycemia and strict glycemic control can lower the risk of gastrointestinal cancer by reducing hyperglycemic burden.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Additionally, for some individuals, lifestyle changes such as managing metabolic syndrome or abstaining from alcohol may also be helpful.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35197","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T12:47:22Z","timestamp":1704890842000},"page":"1807-1815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study"],"prefix":"10.1002","volume":"130","author":[{"given":"Byeong Yun","family":"Ahn","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bokyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics College of Medicine The Catholic University of Korea  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Gyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science Soongsil University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-0589","authenticated-orcid":false,"given":"Soo\u2010Jeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital Seoul National University College of Medicine  Seoul 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