Hana Park, Ji Young Lee, Ja Eun Koo, Jong Soo Lee, Sungwon Park, Hye Won Park, Hye-Sook Chang, Hong-Kyu Kim, Jaewon Choe, Ju Hyun Shim
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引用次数: 0
Abstract
Background/aims: The recently proposed classification of steatotic liver disease (SLD) comprises metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). Long-term cancer risk across these phenotypes remains incompletely characterized, and was investigated in this study.
Methods: This longitudinal cohort study included 43,994 adults who underwent health check-ups in 2010-2011. Liver steatosis was diagnosed by ultrasonography. The Fibrosis-4 (FIB-4) and steatosis-associated fibrosis estimator (SAFE) scores were evaluated as predictors of cancer incidence.
Results: Over a median 10.5 years (398,202 person-years), 3,169 cancers occurred (795.8 per 100,000 person-years). Versus no SLD, overall cancer risk was elevated in ALD (incidence rate ratio [IRR], 1.38; 95% confidence interval, 1.08 to 1.79) but not MASLD or MetALD. Hepatocellular carcinoma risk increased across all SLD groups, most strongly in the MetALD and ALD groups, with a more modest association in the MASLD group that was attenuated in sensitivity analyses. ALD was associated with an elevated risk of esophageal cancer (IRR, 5.98) and stomach cancer (IRR, 2.41), and MetALD with an increased risk of stomach cancer (IRR, 1.61). FIB-4 and SAFE showed dose-response associations with cancer that were substantially attenuated after age adjustment, persisting mainly at the highest categories.
Conclusions: Cancer risk differs across MASLD, MetALD, and ALD, with alcohol-related phenotypes carrying the highest burden. Noninvasive fibrosis indices such as FIB-4 and SAFE may help stratify risk-though largely age-related-and could inform risk-based surveillance in SLD.
期刊介绍：
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology.
Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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