Evidence map›Paper›PMID 41203958›Full record

ArticleDigestive diseases and sciences2026

The Association Between Physical Activity, Sedentary Time, and Sleep with Risk of Hepatocellular Carcinoma in Patients with Cirrhosis.

Samuel Ma, Yossef Alsabawi, Fasiha Kanwal, Hao Duong, Laith Elserag, Amit G Singal, Nicole E Rich, Saira Khaderi, Sumeet K Asrani, Hashem B El-Serag and 1 more

Abstract read
In one paragraph

Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Samuel MaSchool of Medicine, Baylor College of Medicine, Houston, TX, USA.
Yossef AlsabawiSchool of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA.
Fasiha KanwalSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Hao DuongSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Laith ElseragUniversity of Texas at Austin, Austin, TX, USA.
Amit G SingalDivision of Digestive and Liver Diseases, Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Nicole E RichDivision of Digestive and Liver Diseases, Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Saira KhaderiSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Sumeet K AsraniBaylor University Medical Center, Dallas, TX, USA.
Hashem B El-SeragSection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Aaron P ThriftSection of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. aaron.thrift@bcm.edu.

Funding

Translational Research Support CoreP30ES030285 · NIEHS · BAYLOR COLLEGE OF MEDICINE · PI Cheryl L. Walker · 2019 to 2026
$14.7M
Precision Risk Stratification and Screening for HCC among Patients with Indeterminate Liver NodulesU01CA283935 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI HOSHIDA, YUJIN, SINGAL, AMIT · 2023 to 2025
$3.9M
Developmental Reprogramming of Prostate Carcinogenesis by BPARC2ES018789 · NIEHS · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI WALKER, CHERYL L. · 2009 to 2010
$1.9M
Cancer Prevention and Research Institute of Texas RP200554Center for Innovations in Quality, Effectiveness and Safety CIN 13-413Gulf Coast Center for Precision and Environmental Health P30ES030285NCI NIH HHS U01CA283935NIEHS NIH HHS P30 ES030285NIEHS NIH HHS RC2 ES018789
6 · The paper itself

Abstract

backgroundThe majority of hepatocellular carcinoma (HCC) cases arise in patients with cirrhosis, with known major risk factors of hepatitis B (HBV) or C (HCV) infection, metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-associated liver disease (ALD). However, the impact of additional risk factors that act independently or jointly on the pathogenesis of HCC in cirrhosis patients is unknown. The aim of this study was to determine whether sleep, sedentariness, or physical activity levels play a role in the progression of cirrhosis to HCC.

methodsWe systematically collected data on sleep, sedentary time, and physical activity from the ongoing prospective study, the Texas HCC Consortium Cohort, which recruited patients with cirrhosis from December 2016 and followed up until HCC development, death, or May 2024. Hazard ratios (HRs) were calculated using Fine-Gray competing risk regression models to evaluate the independent association between sleep, sedentary, and physical activity levels with the risk of HCC overall and in groups stratified by major HCC risk factors.

resultsOf 3940 patients with cirrhosis (mean age = 59.9 years, 39.1% women), 9.3% of patients had active HCV, 34.6% had MASLD, 41.5% had MetALD, and 3.2% had ALD only. In total, 208 patients developed incident HCC (annual incidence rate, 2.37% [95% CI 2.07, 2.72%]). After adjustment for demographic and clinical factors, absent levels of light physical activity (HR = 0.92 [0.57-1.47]), excessive sitting time (HR = 0.91 [0.57-1.44]), and reduced sleep duration (HR = 0.92 [0.65-1.29]) were not associated with an increased risk of HCC development. There were no associations with increased risk of HCC development across all sub-groups examined.

conclusionsIn this study, the risk of HCC in patients with cirrhosis was not significantly affected by level of light physical activity, sedentariness, or sleep across all major etiologies of cirrhosis.

Indexed as

Carcinoma, HepatocellularExerciseLiver CirrhosisLiver NeoplasmsSedentary BehaviorSleepAgedFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsEpidemiologyLifestyleLiver cancerPrevention

Identifiers

PMID41203958
PMCPMC13144167

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.