MASLD and MetALD Linked to Increased Cancer Risk

TOPLINE:
Metabolic dysfunction–associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and other combination etiologies of steatotic liver disease (SLD) are linked to a higher risk for cancer, particularly liver and gastrointestinal cancers.
METHODOLOGY:
Researchers conducted a nationwide cohort study of 3,596,709 participants aged 40-69 years identified by the National Health Insurance Service database in the Republic of Korea as having undergone health screening.
Participants were categorized into four groups: MASLD, MetALD, other combination etiologies, and no SLD.
The primary outcome was the development of cancer during the follow-up period, and its association with MASLD, MetALD, and other combination etiologies of SLD.
TAKEAWAY:
Among the entire cohort, 2,181,454 had no SLD and 1,415,255 (39.3%) had SLD; the latter group were further categorized into those with MASLD (n = 1,102,225), MetALD (n = 166,359), and other combination SLD etiology (n = 137,710).
During 33.9 million person-years of follow-up, 285,845 participants (7.9%) developed cancers.
The risk of developing cancer was higher for MASLD (subdistribution hazard ratio [SHR], 1.02), MetALD (SHR, 1.07), and other combination etiology (SHR, 1.40; P < .001 for all) than for no SLD.
The risk of developing liver cancer escalated further in patients with MASLD (SHR, 1.16), MetALD (SHR, 2.06), and other combination etiology (SHR, 8.16) than in those with no SLD (P < .001 for all).
Similarly, the risk for gastrointestinal cancers, including esophageal, stomach, colorectal, biliary, and pancreatic cancers, was higher in MASLD (SHR, 1.13), MetALD (SHR, 1.17), and other combination etiology (SHR, 1.09) than in no SLD (P < .001 for all).
The risk for lung cancer and hormone-sensitive cancer, including breast, uterine, and ovarian cancers, was modestly higher in patients with MASLD.
IN PRACTICE:
“The findings suggest that managing MASLD properly and modifying alcohol consumption can serve as a preventative strategy against cancer risk,” the authors wrote.
SOURCE:
The study, led by Yewan Park, Department of Internal Medicine, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea, was published online in Alimentary Pharmacology & Therapeutics.
LIMITATIONS:
Due to the lack of radiological and histological data, the diagnosis of SLD was based solely on the fatty liver index cutoff of ≥ 30, which may be considered a crude measure of defining hepatic steatosis. The study population was exclusively Korean, which may have limited the generalizability of the findings to other ethnic populations.
DISCLOSURES:
This study was supported by grants from the National Research Foundation of Korea and Kyung Hee University. The authors declared that they had no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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