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Non-alcoholic fatty liver disease and colorectal cancer survival

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Abstract

Purpose

Liver diseases including non-alcoholic fatty liver disease (NAFLD) and ensuing alterations to the micro-environment may affect development of liver metastasis. Mirroring the rise in obesity rates, prevalence of NAFLD is increasing globally. Our objective was to examine the association between NAFLD and mortality in colorectal cancer patients.

Methods

Colorectal Cancer-Sarcopenia and Near-term Survival (C-SCANS) is a retrospective cohort study which included 3,262 stage I–III patients, aged 18–80 years, and diagnosed between 2006 and 2011 at Kaiser Permanente Northern California. Cox proportional hazards regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CI).

Results

After up to 10 years of follow-up, 879 deaths, including 451 from CRC were identified. Cases diagnosed with NAFLD before and within 1 month after CRC diagnosis (pre-existing NAFLD; n = 83) had a HR of 1.64 (95% CI 1.06–2.54) for overall and a HR of 1.85 (95% CI 1.03–3.30) for CRC-specific mortality compared to those without NAFLD. Findings did not differ significantly by sex, stage, tumor location, and smoking status, and were also similar when restricted to obese patients only.

Conclusions

Independent of body mass index and prognostic indicators, CRC patients with pre-existing NAFLD had a worse prognosis than those without NAFLD.

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Fig. 1

Abbreviations

BMI:

Body mass index

CRC:

Colorectal cancer

CI:

Confidence interval

HR:

Hazard ratio

KPNC:

Kaiser Permanente Northern California

NAFLD:

Non-alcoholic fatty liver disease

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Funding

Grant from the National Cancer Institute R01CA175011 to Dr. Bette Caan is acknowledged.

Author information

Authors and Affiliations

  1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Kana Wu & Edward Giovannucci

  2. Harvard Medical School, Boston, MA, USA

    Mike Z. Zhai

  3. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Erin K. Weltzien, Elizabeth M. Cespedes Feliciano & Bette J. Caan

  4. Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Jeffrey A. Meyerhardt

  5. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Edward Giovannucci

Authors
  1. Kana Wu
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  2. Mike Z. Zhai
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  3. Erin K. Weltzien
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  4. Elizabeth M. Cespedes Feliciano
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  5. Jeffrey A. Meyerhardt
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  6. Edward Giovannucci
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  7. Bette J. Caan
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Corresponding author

Correspondence to Kana Wu.

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Wu, K., Zhai, M.Z., Weltzien, E.K. et al. Non-alcoholic fatty liver disease and colorectal cancer survival. Cancer Causes Control 30, 165–168 (2019). https://doi.org/10.1007/s10552-018-1095-z

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  • DOI: https://doi.org/10.1007/s10552-018-1095-z

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