MASLD, MetALD tied to increased cancer risk

Metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with increased alcohol intake (MetALD) may predispose affected individuals to liver and gastrointestinal cancers, as reported in a study.

A nationwide cohort of 3,596,709 participants who underwent a health check-up in South Korea were included in the study. Of the participants, 1,415,255 (39.3 percent) had steatotic liver disease (SLD), defined as a fatty liver index ≥30. A total of 1,102,225 SLD participants with cardiometabolic risk factors had MASLD, 166,359 had MetALD, and 137,710 had other combination aetiology.

Compared with participants with no SLD (n=2,181,454), a higher proportion of those with MASLD, MetALD, and other combination aetiology were men (37.8 percent vs 66.8 percent vs 92.6 percent vs 84.0 percent, respectively), had diabetes (10.9 percent vs 19.8 percent vs 15.9 percent vs 27.5 percent, respectively), and had hypertension (24.7 percent vs 44.5 percent vs 42.0 percent vs 48.8 percent, respectively).

Over 33.9 million person-years of follow-up, 285,845 participants (7.9 percent) received cancer diagnoses, which tended to occur more frequently among participants with MASLD, MetALD, and other combination aetiology than among those without SLD.

Specifically, the risk of liver cancer increased progressively from 1.16-fold in the MASLD group (subdistribution hazard ratio [SHR], 1.16, 95 percent confidence interval [CI], 1.12–1.21) to twofold in the MetALD group (SHR, 2.06, 95 percent CI, 1.92–2.20) and eightfold in the group with other combination aetiology (SHR, 8.16, 95 percent CI, 7.69–8.67) relative to the no SLD group.

The risk of gastrointestinal cancers, including those in the oesophagus, stomach, colorectal, biliary, and pancreas, was also elevated the MASLD (SHR, 1.13, 95 percent CI, 1.11–1.15), MetALD (SHR, 1.17, 95 percent CI, 1.14–1.21), and other combination aetiology groups (SHR, 1.09, 95 percent CI, 1.05–1.13) relative to the no SLD group.

Participants with MASLD had a modest increase in lung cancer and hormone-sensitive cancer.