Nonalcoholic fatty liver disease is specifically related to the risk of hepatocellular cancer but not extrahepatic malignancies

Somaya Albhaisi; Donna McClish; Le Kang; Tamas Gal; Arun J Sanyal

doi:10.3389/fendo.2022.1037211

Nonalcoholic fatty liver disease is specifically related to the risk of hepatocellular cancer but not extrahepatic malignancies

Front Endocrinol (Lausanne). 2022 Nov 25:13:1037211. doi: 10.3389/fendo.2022.1037211. eCollection 2022.

Authors

Somaya Albhaisi¹, Donna McClish², Le Kang², Tamas Gal², Arun J Sanyal³

Affiliations

¹ Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States.
² Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States.
³ Divsion of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States.

Abstract

Objective: We performed a matched cohort study among individuals with and without nonalcoholic fatty liver disease (NAFLD) to determine: 1) the incidence of cancers (extrahepatic and liver) and their spectrum and 2) if NAFLD increases the risk of extrahepatic cancers.

Methods: The NAFLD and non-NAFLD (control) cohorts were identified from electronic medical records via International Classification of Diseases (ICD) codes from a single center and followed from 2010 to 2019. Cohorts were matched 1:2 for age, sex, race, body mass index (BMI), and type 2 diabetes.

Results: A total of 1,412 subjects were included in the analyses. There were 477 individuals with NAFLD and 935 controls (median age, 52 years; women, 54%; white vs. black: 59% vs. 38%; median BMI, 30.4 kg/m²; type 2 diabetes, 34%). The cancer incidence (per 100,000 person-years) was 535 vs. 1,513 (NAFLD vs. control). Liver cancer incidence (per 100,000 person-years) was 89 in the NAFLD group vs. 0 in the control group, whereas the incidence of malignancy was higher across other types of cancer in the control group vs. in the NAFLD group.

Conclusions: The overall extrahepatic cancer risk in NAFLD is not increased above and beyond the risk from background risk factors such as age, race, sex, BMI, and type 2 diabetes.

Keywords: NAFLD; NASH; cancer; diabetes mellitus; metabolic syndrome; obesity.

MeSH terms

Carcinoma, Hepatocellular*
Cohort Studies
Diabetes Mellitus, Type 2* / epidemiology
Female
Humans
Liver Neoplasms* / epidemiology
Liver Neoplasms* / etiology
Middle Aged
Non-alcoholic Fatty Liver Disease* / epidemiology