Metabolic dysfunction-associated fatty liver disease (MAFLD) increases risk for colorectal cancer (CRC), particularly in individuals with liver fibrosis, according to a study published in Clinical and Translational Gastroenterology.

Previous studies have shown an association between nonalcoholic fatty liver disease (NAFLD) and CRC. However, the association between the 2 conditions remains a source of controversy due to conflicting data. For the current study, researchers sought to determine whether the newly defined MAFLD, a type of fatty liver disease (FLD), was associated with an increased risk for CRC.

Using a nationwide health information database in South Korea, researchers identified 8,933,017 participants for the study. Patients were categorized by the presence of NAFLD, MAFLD, and a combination of both definitions (neither type of FLD, NAFLD only, MAFLD only, or both types of FLD). Developing CRC was the primary outcome.


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The researchers found that 28.2% of study participants had NAFLD, 37.4% had MAFLD, and 27.6% satisfied both NAFLD and MAFLD definitions. A total of 60,888 new CRC cases developed over a median follow-up period of 10.1 years.

NAFLD and MAFLD were each related to a significantly higher risk for developing CRC. With the “neither FLD” group as the reference, multivariable-adjusted hazard ratios (HR) indicated that CRC associated with the NAFLD only group (HR, 1.16; 95% CI, 1.06-1.28), the both FLD group (HR, 1.18; 95% CI, 1.16-1.20), and the MAFLD only group (HR, 1.32; 95% CI, 1.28-1.35). In addition, among study participants in the FLD group, advanced liver fibrosis further increased risk for CRC.

“In our study, FLD was consistently associated with CRC risk in the presence or absence of liver fibrosis, suggesting that the risk [for] CRC development may be elevated even in a mild form of FLD without progression to advanced fibrosis,” the study authors wrote. “…We also found that MAFLD was associated with a higher risk [for] CRC even in the subgroup of youngest age (40-44 years), which is below the recommended CRC screening age. Further studies should explore whether CRC surveillance should commence at a younger age in patients with FLD.”

Reference

Lee H, Lee HW, Kim SU, Kim HC. Metabolic dysfunction–associated fatty liver disease increases colon cancer risk: A nationwide cohort study. Clin Transl Gastroenterol. Published online January 12, 2022. doi:10.14309/ctg.0000000000000435