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TOPLINE:

Patients with steatotic liver disease (SLD) showed an elevated risk for colorectal cancer (CRC), with the highest risk observed in those with alcohol-associated liver disease (ALD), followed by those with metabolic dysfunction–associated SLD (MASLD) and those with MASLD and increased alcohol intake (MetALD).

METHODOLOGY:

• Obesity and alcohol consumption are proven risk factors for CRC, but variations in risk among the subgroups of SLD (MASLD, MetALD, and ALD) are unclear.
• Researchers conducted a nationwide, population-based cohort study to examine the risk for CRC in 1,497,813 patients with SLD; 4,885,536 individuals without known liver disease were chosen as the comparison group.
• Patients were grouped into those with MASLD (n = 978,792; median age, 44.2 years; 76.6% men), MetALD (n = 366,254; median age, 47.3 years; 91.9% men), and ALD (n = 152,767; median age, 48.3 years; 95.5% men) based on cardiometabolic criteria and self-reported alcohol consumption habits obtained via questionnaire data.
• The primary endpoint was the occurrence of CRC in each SLD subgroup.

TAKEAWAY:

• Over a median follow-up period of 4.5 years, 12,065 patients (0.19%) developed CRC.
• The 5- and 10-year cumulative incidence rates of CRC were highest in patients with ALD (0.43% and 0.97%, respectively), followed by those with MetALD (0.32% and 0.73%, respectively), those with MASLD (0.22% and 0.48%, respectively), and the comparison group (0.15% and 0.32%, respectively; all P < .0001).
• Using the comparison group as a reference and adjusting for multiple factors, including age, sex, smoking habit, and comorbidities, the adjusted hazard ratio for the risk for CRC was 1.73 for ALD, 1.36 for MetALD, and 1.28 for MASLD (all P < .001).

IN PRACTICE:

“These results support the utility of the new consensus nomenclature for risk stratification of CRC in patients with SLD,” the authors wrote. “This study underscores the importance of ongoing research into the pathophysiology of CRC in patients with SLD, particularly in relation to alcohol intake and metabolic dysfunction.”

SOURCE:

This study, led by Takefumi Kimura, MD, PhD, and Shun-Ichi Wakabayashi, MD, PhD, both of Shinshu University School of Medicine, Nagano, Japan, and Nobuharu Tamaki, MD, PhD, Musashino Red Cross Hospital, Tokyo, Japan, was published online in Clinical Gastroenterology and Hepatology.

LIMITATIONS:

The study population mainly included younger men, which potentially limited the generalizability of the findings to women and older adults. This study was conducted in a Japanese population, which necessitates further validation in diverse ethnic and racial groups for broader applicability. Researchers used the fatty liver index for identification of SLD and relied on self-reported data for alcohol consumption.

DISCLOSURES:

Several authors received funding support from the Japan Agency for Medical Research and Development and Ministry of Health, Labour and Welfare of Japan, and other sources. One author reported being a consultant and having stock options and other ties with several pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.