- Biopsy-proven nonalcoholic steatohepatitis (NASH) is tied to an increased risk for advanced colorectal neoplasm in patients with nonalcoholic fatty liver disease (NAFLD).
Why this matters
- Findings warrant screening for colorectal cancer in patients with NAFLD.
- Study of 476 patients aged ≥18 years with clinically suspected NAFLD who underwent screening colonoscopy as part of a biopsy-evaluated prospective cohort.
- Funding: Seoul Metropolitan Government, Seoul National University, Boramae Medical Center.
- 379 patients (79.6%) had biopsy-determined NAFLD, including 194 patients with NASH; the remainder (n=97) had no evidence of NAFLD and comprised the "healthy controls" arm.
- 11.1% had advanced colorectal neoplasm (mean number, 3.0±3.5), 21.0% had low-grade polyps (mean number, 3.1±2.2), and 67.9% showed no evidence of polyps.
- Patients with advanced colorectal neoplasms had higher grades of steatosis (P=.004) and hepatic fibrosis (P=.044).
- Advanced colorectal neoplasms were more common in patients with nonalcoholic fatty liver (12%; P=.003) and NASH (13%; P=.05) than healthy controls (5%).
- In multivariate analysis adjusting for age, sex, hypertension, and diabetes, NASH (vs no NAFLD) was tied to increased risks for:
- Colorectal polyp (OR=2.08; P=.020).
- Advanced colorectal neoplasm (OR=2.81; P=.049).
- Cross-sectional design.