Fatty liver in 20s and 30s tied to about 20% higher cancer risk before 50: study

A Korean team spanning Seoul National University Bundang Hospital (SNUBH), Korea University and Boramae Hospital reports that people in their 20s and 30s with fatty liver disease have about a 20 percent higher chance of being diagnosed with cancer before age 50 than peers without it. 

The findings, published in Clinical Gastroenterology and Hepatology, come from 2,877,245 National Health Screening participants followed for up to 10 years, with 46,729 incident cancers across 23 organ sites. 

Fatty liver disease -- now often called steatotic liver disease -- means excess fat in the liver driven by weight gain, diabetes, cholesterol problems or alcohol. The risk bump showed up across all subtypes: metabolically driven fatty liver was linked to a 19 percent higher overall cancer risk, a combined metabolic-plus-alcohol form to 12 percent, and alcohol-related fatty liver to 21 percent.

The strongest signals were in cancers commonly tied to obesity. Relative risk rose up to 1.32 for colorectal cancer, 1.53 for kidney cancer, 1.36 for thyroid cancer and 3.78 for endometrial cancer. Risk climbed with each additional cardiometabolic problem (such as larger waist size, higher blood pressure or high blood sugar).

The authors point to rising obesity, alcohol use and physical inactivity among younger adults as context for the findings and argue for screening strategies tailored to this population. 

“Cancers that occur before age fifty often progress quickly and behave aggressively, so prognosis can hinge on early detection and treatment,” said Moon Joon-ho, professor of internal medicine of SNUBH, adding that integrated screening and monitoring could improve outcomes for young adults with obesity and fatty liver disease.