SAN FRANCISCO — Patients with non-alcoholic fatty liver disease carried a 91% higher risk for malignancy and the risk for cancer with obesity is “driven by NAFLD,” according to a presentation at The Liver Meeting 2018.
“The risk of malignancy was higher in NAFLD vs. controls ... 91% higher than the general population when we take all cancers into account,” Alina M. Allen, MD, of Mayo Clinic, Rochester, Minn., said during her presentation. “Obesity is associated with a higher risk of cancer only in those with NAFLD and not in those without.”
Using ICD-9 and ICD-10 codes, Allen and colleagues looked at data from Mayo Clinic from 1997 to 2017 to determine the incidence of cancers after diagnosis of NAFLD. They included 19,223 subjects, 14,432 classified as controls and 4,791 diagnosed with NAFLD.
“The increase is highest in GI cancers: liver, stomach, pancreas and colon,” Allen said.
When broken down, the risks of cancer were higher for those with NAFLD in the following cancers: liver (RR = 3.24), uterus (RR = 2.39), stomach (RR = 2.34), pancreas (RR = 2.09) and colon (RR = 1.76).
Allen then showed that there were differences by sex, most notably observing, “the increased risk in colon cancer ... is derived entirely by men.”
Additionally, the cancer occurrence was seen at a younger age in patients with NAFLD compared with controls, especially in colon and pancreatic cancer.
“We note that in both females and men the risk of malignancy is much higher at younger ages,” Allen said.
Lastly, Allen showed that when compared with controls with obesity but without NAFLD, the NAFLD cohort carried nearly all the incident cancer risk.
“This novel data suggests that the obesity related increased risk of malignancy is driven by NAFLD,” she said. – Katrina Altersitz
Allen A, et al. Abstract 31. Presented at: The Liver Meeting 2018; Nov. 9-13, 2018; San Francisco, CA.
Disclosure: Author reports no relevant financial disclosures.