To analyze the changes in mortality and DALYs of cancer attributed to high Body-Mass Index (BMI) from 1990 to 2021 in China, to provide scientific basis for formulating prevention and control strategies for cancer.

Data on mortality and DALY rates attributed to high BMI in China from 1990 to 2021 were extracted from the Global Burden of Disease(GBD) 2021 database. The Joinpoint software was used to analyze the trends of these mortality and DALY rates, while age-period-cohort models were employed to investigate the effects of age, period, and cohort.

Compared with 1990, the standardized mortality rate and DALY of cancer attributed to high BMI in China showed an upward trend in 2021, with increases of 106.62% and 102.27%, respectively, and AAPCs of 2.4% and 2.3%. From 1990 to 2021, the mortality rate and DALY of cancer attributed to high BMI in various age groups in China showed an upward trend, with a significantly faster increase in the 25- and 60-79-year-old age groups. The global changes in the standardized mortality rate of cancer attributed to high BMI among Chinese populations, including men and women, from 1990 to 2019 were 1.92(95% CI: 1.80-2.04), 2.74(95%CI: 2.60-2.88), and 0.94(95% CI: 0.80-1.07), respectively; The global changes in standardized DALY rates were 1.97(95% CI:1.86-2.08), 2.76(95% CI:2.62-2.90), and 1.02(95% CI:0.93-1.11), respectively.

From 1990 to 2021, the burden of cancer attributed to high BMI in China shows an upward trend, with the most rapid growth among males and people aged 60-79 years. Effective strategies for the prevention and control of overweight and obesity should be implemented to reduce the burden of cancer.