Metabolic-associated fatty liver disease and risk of esophagogastric cancer: a systematic review and meta-analysis

Introduction Metabolic-associated fatty liver disease (MAFLD) has been found to be strongly linked to several diseases. Although previous studies have explored the association between MAFLD and extrahepatic cancers, research on the relationship between MAFLD and gastric carcinoma (GC) and esophageal carcinoma (EC) is relatively scarce and requires updating. Therefore, the objective of this study is to conduct a comprehensive investigation into the association between MAFLD and GC or EC. Material and methods We conducted a comprehensive search for relevant studies published up to 5 August 2022, using the PubMed, Embase and Web of Science databases. To estimate the risk ratio (RR) and the 95% confidence interval (CI), we employed a random-effects model. We also conducted subgroup analyses based on study characteristics. The protocol for this systematic review is registered in the Prospero database under the registration number CRD42022351574. Results Our analysis included eight eligible studies, comprising a total of 8 629 525 participants. We found that the pooled RR values for the risk of GC in patients with MAFLD were 1.49 (95%CI: 1.17-1.91), whereas the pooled RR values for the risk of EC in patients with MAFLD were 1.76 (95%CI: 1.34-2.32). Conclusions Based on our meta-analysis, we conclude that there is a significant association between the presence of MAFLD and the development of GC and EC. MAFLD is associated with a nearly 1.5- to 2-fold increased risk of developing esophagogastric cancer. The risk is independent of smoking, alcohol, physical activity, BMI, diabetes and other potential confounders.