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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\u2019s 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.<\/jats:p>","DOI":"10.1038\/s41598-025-13045-9","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T04:44:33Z","timestamp":1754541873000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A burden of proof study of the effects of exposure to high fasting plasma glucose on the risk of seven types of cancer"],"prefix":"10.1038","volume":"15","author":[{"given":"Paula Portal","family":"Teixeira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne Yiru","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandr","family":"Aravkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Force","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kocarnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Vos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Lenox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon I.","family":"Hay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce Bartholow","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f4nica","family":"Colpani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Gerchman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanyin Liane","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"13045_CR1","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","volume":"403","author":"GBD 2021 Diseases and Injuries Collaborators","year":"2024","unstructured":"GBD 2021 Diseases and Injuries Collaborators. 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