A new study from Japan has found that the risk of colorectal cancer (CRC) varies among different types of steatotic liver disease (SLD), with alcohol-associated liver disease (ALD) carrying the highest risk.
The findings, published in Clinical Gastroenterology and Hepatology, emphasize the need for targeted cancer screening in high-risk patients.
Both alcoholic and non-alcoholic fatty liver disease (NAFLD) are known risk factors for colorectal cancer, one of the leading causes of cancer-related deaths.
NAFLD has recently been reclassified under the broader term steatotic liver disease (SLD), which includes different subgroups based on alcohol intake:
- Metabolic dysfunction-associated SLD (MASLD) – Previously called NAFLD, this form is linked to obesity and metabolic disorders.
- MASLD with increased alcohol intake (MetALD) – Patients have metabolic issues but also consume alcohol above a certain threshold.
- Alcohol-associated liver disease (ALD) – Liver disease primarily caused by heavy alcohol consumption.
While scientists have long known that alcohol and obesity increase CRC risk, it was unclear whether different SLD subgroups have different levels of risk.
To answer this question, Dr. Takefumi Kimura from Shinshu University School of Medicine, Japan, along with Dr. Nobuharu Tamaki and Dr. Shun-Ichi Wakabayashi, led a nationwide population-based study.
The study analyzed data from 6.38 million individuals to compare CRC risk among SLD patients and those without liver disease.
The results showed that 0.19% of patients developed CRC over a 4.5-year period. However, the risk was significantly different among the SLD subgroups:
- ALD patients had the highest risk—1.73 times greater than those without liver disease.
- MetALD patients had 1.36 times higher risk.
- MASLD patients had 1.28 times higher risk.
Researchers believe that different mechanisms may explain why certain liver disease groups face higher colorectal cancer risk:
- Alcohol’s role in CRC – Heavy drinking may damage DNA, cause oxidative stress, and produce toxic byproducts, which can lead to cancerous changes in the colon.
- Metabolic dysfunction and inflammation – MASLD/NAFLD is strongly linked to obesity, insulin resistance, and chronic inflammation, all of which are known to contribute to cancer development.
Dr. Kimura emphasizes that early detection is key to improving patient outcomes. He states:
“Identifying and screening patients with SLD at a higher risk of developing colorectal cancer can enable early detection and improve patient outcomes.”
The study highlights the need for enhanced CRC screening programs focused on high-risk groups, especially ALD and MetALD patients.
This research provides strong evidence that alcohol and metabolic dysfunction play individual and combined roles in increasing colorectal cancer risk. Moving forward, doctors should prioritize regular CRC screening for patients with liver disease, particularly those in the ALD and MetALD groups.
By improving early detection, targeted screening programs could help reduce CRC-related deaths and improve overall patient care.
If you care about liver health, please read studies about simple habit that could give you a healthy liver, and common diabetes drug that may reverse liver inflammation.
For more information about health, please see recent studies about simple blood test that could detect your risk of fatty liver disease, and results showing this green diet may strongly lower non-alcoholic fatty liver disease.
The research findings can be found in Clinical Gastroenterology and Hepatology.
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