ArticleJournal of gastrointestinal cancer2025
A Higher Risk of Liver Cancer in Alcoholic Fatty Liver Disease than in Non-Alcoholic Fatty Liver Disease: an Analysis of the TriNetX Dabatase.
Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundBoth alcohol fatty liver disease (AFLD) and non-alcohol fatty liver disease (NAFLD) are established risk factors for liver cancer development. We conduct a comparative analysis between AFLD and NAFLD to determine which condition contributes a greater burden to liver cancer incidence.
methodsData were obtained from the TriNetX research network. Individuals aged ≥ 20 years with newly diagnosed fatty liver disease between 2008 and 2021 were included. Participants were categorized into two groups: AFLD and NAFLD. Patients with a history of hepatic cirrhosis, liver cancer, hepatitis B, or hepatitis C before the index date were excluded. Propensity score matching was performed based on age, sex, and comorbidities, resulting in a balanced 1:1 matched cohort. Comparative analyses were conducted between the AFLD and NAFLD cohorts to assess differences in liver cancer risk profiles.
resultsA total of 13,998 AFLD and 1,165,365 NAFLD cases were analyzed. After propensity score matching, both cohorts consist of 13,998 individuals. At the 2- and 3-year follow-ups, the risk became statistically significant and showed a progressive increase, with relative risks approaching a two-fold elevation in the AFLD group. Cumulatively, by the final follow-up, AFLD patients demonstrated a markedly higher incidence of liver cancer (0.950% vs. 0.493%), confirming a sustained and significantly elevated risk even after adjustment for baseline characteristics.
conclusionPatients with AFLD exhibited an approximately two-fold increased risk of liver cancer development over a 3-year follow-up period compared to those with NAFLD. This finding underscores the urgent need for comprehensive recognition and mitigation of alcohol-associated hepatocarcinogenesis.
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