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Liver Fibrosis Marker FIB-4 Is Associated With Hepatic and Extrahepatic Malignancy Risk in a Population-Based Cohort Study

  • 0Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel.
Liver International : Official Journal of the International Association for the Study of the Liver +

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May 13, 2025

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May 13, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Advanced liver fibrosis, indicated by the Fibrosis-4 score, significantly increases the risk of developing various cancers, including liver and bile duct malignancies. This finding suggests fibrosis markers can identify high-risk individuals for cancer surveillance.

Area Of Science

  • Hepatology
  • Oncology
  • Epidemiology

Background

  • Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is linked to extrahepatic cancers.
  • The specific role of liver fibrosis in extrahepatic cancer development remains unclear.
  • This study investigates the long-term association between liver fibrosis markers and cancer incidence.

Purpose Of The Study

  • To evaluate the long-term association between liver fibrosis markers and the incidence of both hepatic and extrahepatic malignancies.
  • To determine if liver fibrosis is an independent risk factor for cancer development.
  • To assess the predictive value of liver fibrosis in identifying individuals at high risk for cancer.

Main Methods

  • Retrospective cohort study of 763,752 adult health service members.
  • Follow-up period of 14.67 years, excluding individuals with prior liver disease or malignancies.
  • Fibrosis-4 (FIB-4) score assessed from routine labs; advanced fibrosis defined as FIB-4 ≥ 2.67. Multivariable Cox regression used for analysis.

Main Results

  • Advanced fibrosis (FIB-4 ≥ 2.67) was associated with a 16% increased risk of overall malignancy (HR=1.16).
  • The association was stronger with age-specific FIB-4 cutoffs (HR=1.40) and in individuals with MASLD (HR=1.43).
  • Both inconclusive and advanced fibrosis showed strong associations with liver and bile duct cancers (HRs 1.41 and 5.66, respectively).

Conclusions

  • Liver fibrosis score is an independent predictor of malignancy occurrence.
  • Specific types of malignancies, particularly liver and bile duct cancers, are strongly associated with liver fibrosis.
  • Liver fibrosis markers may serve as valuable indicators for identifying high-risk populations for cancer screening.

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