Rising lung cancer burden attributable to high fasting plasma glucose in women aged ≥50 years: age-, SDI-, and BRICS-specific patterns from GBD 1990–2021

Background: We quantified trends and heterogeneity in lung cancer burden attributable to high fasting plasma glucose (HFPG) among women aged ≥50 years (used as a population-level proxy for postmenopausal status) globally and across BRICS countries from 1990 to 2021. Methods: HFPG-attributable lung cancer deaths and DALYs for women ≥50 years were obtained from GBD 1990–2021. Burden was summarized as numbers and age-standardized rates (ASR) per 100,000, stratified by age, SDI quintile, and country. Trends were assessed using EAPC from log-linear regression. Results: Global HFPG-attributable deaths and DALYs increased markedly from 1990 to 2021, with rising ASR (global EAPC 1.21; 95% CI, 1.11–1.31). A strong age gradient was observed; EAPC increased from 0.53% (50–54 years) to 3.65% (≥95 years). In 2021 the DALYs ASR peaked in the 75–79-year group (59.38 per 100,000). High-SDI settings consistently had the highest ASR and increasing burden. In BRICS, DALY ASR increased in all five countries with substantial heterogeneity: India showed the fastest increase (EAPC 3.05; 95% CI, 2.91–3.19), followed by South Africa (2.82; 2.64–3.00) and Brazil (2.36; 2.31–2.42), while China showed the smallest increase (0.87; 0.70–1.03). Conclusions: HFPG-attributable lung cancer burden in women aged ≥50 years rose substantially from 1990 to 2021, with disproportionate growth in older ages and clear SDI/BRICS differences, supporting integrated metabolic prevention within cancer control and healthy aging strategies.