Association between Metabolic Dysfunction-Associated Steatotic Liver Disease and Esophageal, Stomach Cancer: A Nationwide Cohort Study.

Background/Aims In June 2023, an international panel of experts put forth a proposal to introduce a new classification system for steatotic liver disease (SLD), which would replace the previous terminology of nonalcoholic fatty liver disease (NAFLD). The objective of this study was to examine the relationship between the various subtypes of SLD and the subsequent development of esophageal and gastric cancers. Methods We identified participants who underwent health screenings in 2009 and 2010 using the KNHIS database and conducted a retrospective analysis of their data through 2019. The subjects were classified into four categories: no SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol- related liver disease (ALD). Hepatic steatosis was defined as fatty liver index ≥30. The primary outcome was the occurrence of newly diagnosed esophageal and gastric cancers. Results There were 109,698 male (50.8%) and 105,868 female (49.2%). The prevalence of no SLD, MASLD, MetALD, and ALD was 63.3%, 31.9%, 3.7%, and 1.0%, respectively. The adjusted hazard ratio (aHR) of the incidence of esophageal cancer was derived as MASLD 0.81 [95% CI: 0.61-1.08], MetALD 1.58 [95% CI: 1.00-2.51], and ALD 2.23 [95% CI: 1.20-4.14] using No SLD as a reference. The aHR of the incidence of stomach cancer was derived as MASLD 1.08 [95% CI: 1.01-1.60], MetALD 1.38 [95% CI: 1.19-1.60], and ALD 1.39 [95% CI: 1.09-1.76] using No SLD as a reference. Conclusion There is a notable correlation between esophageal cancer and ALD. Individuals with MASLD, MetALD, and ALD are at an elevated risk of developing gastric cancer. [ABSTRACT FROM AUTHOR]