The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Risk of nonalcoholic fatty liver disease and associations with gastrointestinal cancers
Commun. 2022 Oct 11. doi: 10.1002/hep4.2073. Online ahead of print.
1Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
2Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
3Brown School, Washington University in St. Louis, St. Louis, Missouri, USA.
4Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
5Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
6Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
7Department of Gastroenterology, Kaiser Permanente Northern California, San Francisco, California, USA.
8Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
9Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA.
Abstract
Metabolic syndrome may contribute to the rising incidence of multiple gastrointestinal (GI) cancers in recent birth cohorts. However, other than hepatocellular carcinoma, the association between nonalcoholic fatty liver disease (NAFLD) and risk of non-liver GI cancers is unexplored. We prospectively examined the associations of NAFLD risk with GI cancers among 319,290 participants in the UK Biobank (2006-2019). Baseline risk for NAFLD was estimated using the Dallas Steatosis Index, a validated prediction tool. Multivariable Cox models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) according to NAFLD risk categories: low (<20%), intermediate (20%-49%), and high (≥50%). We also examined the associations by age of cancer diagnosis (earlier onset [<60] vs. ≥60). A total of 273 incident liver cancer and 4789 non-liver GI cancer cases were diagnosed. Compared with individuals at low risk for NAFLD, those at high risk had 2.41-fold risk of liver cancer (RR = 2.41, 95% CI: 1.73-3.35) and 23% increased risk of non-liver GI cancers (RR = 1.23, 95% CI: 1.14-1.32) (all ptrend < 0.001). Stronger associations were observed for men and individuals who were obese (all pinteraction < 0.05). NAFLD-associated elevated risk was stronger for earlier-onset cancers. For each 25% increase in NAFLD risk, the RRs for earlier-onset cancers were 1.32 (95% CI: 1.05-1.66) for esophageal cancer, 1.35 (95% CI: 1.06-1.72) for gastric cancer, 1.34 (95% CI: 1.09-1.65) for pancreatic cancer, and 1.10 (95% CI: 1.01-1.20) for colorectal cancer. Conclusion: NAFLD risk was associated with an increased risk of liver and most GI cancers, especially those of earlier onset.