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Clinical Summary

Does nonalcoholic fatty liver disease increase colorectal cancer risk?

Takeaway

  • This meta-analysis suggests that nonalcoholic fatty liver disease (NAFLD) was independently associated with a moderately increased prevalence and incidence of colorectal cancer in asymptomatic adults (predominantly Asian descent) who underwent screening colonoscopy.

Why this matters

  • Finding suggests that a diagnosis of NAFLD could identify a subset of individuals who are at higher risk of having colorectal cancer, and who could need careful surveillance.

Study design

  • Systematic review and meta-analysis of 11 observational studies including 91,124 asymptomatic adults undergoing screening colonoscopy from January 2000 to November 2017.
  • Funding: None disclosed.

Key results

  • Overall, NAFLD was reported in 29,319 patients and accounted for a total of 14,911 colorectal adenomas and 1684 cancers.
  • NAFLD was moderately associated with an increased risk for prevalent colorectal tumours (overall random-effects OR, 1.40; 95% CI, 1.24-1.57) independent of age, sex, BMI, smoking, hypertension, diabetes or metabolic syndrome for both adenomas and cancer.
  • Independent moderate association was seen between NAFLD and the increased risk for incident colorectal tumours (overall random-effects HR, 1.47; 95% CI, 1.20-1.81) and was consistent for both adenomas (HR, 1.42; 95% CI, 1.18-1.72) and cancer (HR, 3.08; 95% CI, 1.02-9.03).

Limitations

  • Risk for bias.
  • Residual confounding could not be ruled out.

References


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