Nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of young-onset digestive tract cancers, according to study results published in the Journal of Clinical Oncology.

Researchers found that individuals with NAFLD had a higher risk of young-onset digestive tract cancers overall as well as stomach, colorectal, liver, pancreatic, biliary tract, and gallbladder cancers.

This nationwide cohort study included data from 5,265,590 adults aged 20-39 years who underwent South Korean national health screening between 2009 and 2012. During 38.8 million person-years of follow-up, 14,565 patients were diagnosed with young-onset digestive tract cancers.

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Compared to the cancer-free patients, those who had young-onset digestive tract cancers were older, more likely to be women, more likely to be smokers, and less likely to have low-income status (P <.01 for all). The cancer patients also had higher BMIs, blood pressure, and fasting glucose levels (P <.01 for all).

NAFLD was present in 1,336,571 patients at baseline (25.4%). After the researchers adjusted for multiple potential confounders, they found that NAFLD was associated with an increased risk of: 

  • Digestive tract cancers overall (adjusted hazard ratio [aHR], 1.16; 95% CI, 1.10-1.22)
  • Gallbladder cancer (aHR, 1.53; 95% CI, 1.01-2.31)
  • Liver cancer (aHR, 1.31; 95% CI, 1.12-1.52)
  • Biliary tract cancer (aHR, 1.29; 95% CI, 1.00-1.66)
  • Pancreatic cancer (aHR, 1.23; 95% CI, 1.09-1.40)
  • Stomach cancer (aHR, 1.14; 95% CI, 1.06-1.24)
  • Colorectal cancer (aHR, 1.14; 95% CI, 1.06-1.22). 

“Since NAFLD is modifiable, the detection and proper management of NAFLD early in life may help reduce the risk of young-onset digestive tract cancers,” the researchers wrote. “These study results provide an important opportunity to reduce premature morbidity and mortality associated with young-onset digestive tract cancers in the next generation.”

 Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 


Park J-H, Hong JY, Shen JJ, et al. Increased risk of young-onset digestive tract cancers among young adults age 20-39 years with nonalcoholic fatty liver disease: A nationwide cohort study. J Clin Oncol. Published online April 19, 2023. doi:10.1200/JCO.22.01740

This article originally appeared on Cancer Therapy Advisor