Global Burden, Rising Trends, and Future Projections of Metabolic Risks‐Related Pancreatic Cancer, With Subgroup Analysis of High Body Mass Index

ABSTRACT Background Pancreatic cancer (PC) is a global health challenge with increasing incidence and mortality. Metabolic risks, especially high body mass index (BMI), are implicated in PC development, but their impact requires a recent data assessment. This study aimed to assess the global burden and trends of PC attributable to metabolic risks from 1990 to 2021 and project future patterns to 2050. Methods We analyzed Global Burden of Disease 2021 data to assess the effects of metabolic risk on PC using deaths, disability‐adjusted life years (DALYs), years lived with disability, and years of life lost, along with their age‐standardized rates. Trends were evaluated with estimated annual percentage change and projected using autoregressive integrated moving average and exponential smoothing models. Results During 1990–2021, the global PC burden owing to metabolic risks rose significantly, with deaths and DALYs showing marked upward trends. In 2021, 138,517 PC deaths occurred globally (95% uncertainty interval [UI]: 14,518–263,207), with 2,897,229 DALYs (95% UI: 302,694–5,532,210). The estimated annual percentage change for deaths and DALYs was 2.16 (95% confidence interval [CI]: 1.85–2.47) and 1.99 (95% CI: 1.74–2.24), respectively. High‐sociodemographic index (SDI) regions had the greatest burden; low‐middle‐SDI regions showed the fastest increases. The burden related to high BMI rose, with the highest in high‐SDI regions. Men had a greater burden, except for high BMI where women were more affected. Individuals aged ≥ 70 years had the greatest burden. Forecasts predict continued PC growth through 2050, with a narrowing sex gap in mortality. Conclusion The global PC burden owing to metabolic risks, especially high BMI, continues to increase. Targeted prevention strategies to manage obesity and metabolic health are crucial to mitigate future impacts, particularly in women and low‐middle‐SDI regions.