BACKGROUND: Dietary patterns with a high intake of fruits and vegetables (FV) are associated with a reduced risk of various cancers. It is not yet clear where and to what extent a decline in crop productivity caused by climate change may modify the distribution of related cancer burdens through reducing FV consumption in China. To design policies and interventions aimed at improving FV intake, regional monitoring is required on how consumption-changing factors might impact the associated cancer burdens by socio-demographic subpopulations. METHODS: A microsimulation study was conducted from a societal perspective to project the effects of cancers associated with inadequate FV intake attributable to climate change. We linked the International Model for Policy Analysis of Agricultural Commodities and Trade to a health modelling framework for obesity, gastric cancer, lung cancer, and oesophageal cancer in a close-to-reality synthetic population. RESULTS: In the presence of climate constantly change, the relative reduction in FV consumption would induce an additional 9.73 million disability-adjusted life years (DALYs) nationally over the period 2010-2050 ([CrI]: 7.83-12.13). The climate change-induced cancer burden is projected to disproportionately affect socio-demographic index regions from 0.65 to 5.06 million DALYs. CONCLUSIONS: Effects of climate change on FV consumption are anticipated to exacerbate intra-regional inequalities in the associated cancer burdens of China by 2050. By quantitatively analysing the impact of such dietary changes on regional health in light of climate change, our research can inform the design of public health interventions for heterogeneous populations, as health impact assessments based solely on the population as a whole cannot reflect significant differences across subpopulations.