Abstract
New Zealand's rising rates of early-onset colorectal cancer (EOCRC), particularly among Māori, underscore the growing concern about the role of metabolic dysregulation in disease development. There is increasing evidence suggesting that metabolic dysregulation associated with excessive dietary sugar intake may play a central role in colorectal carcinogenesis. Childhood obesity, impaired glucose metabolism and high consumption of sugar-sweetened beverages (SSBs) are prevalent among New Zealand youth, suggesting early metabolic dysfunction may precede and contribute to EOCRC risk. Given this, routinely measured metabolic biomarkers, including glucose and glycated haemoglobin (HbA1c), may offer early risk stratification within primary care settings. This viewpoint also considers whether reductions in SSB consumption could represent a simple and potentially impactful strategy to reduce long-term metabolic disease burden and, consequently, the incidence of EOCRC.