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Updated: Jan 11, 2026
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Metabolic dysfunction-associated steatotic liver disease and colorectal neoplasms risk: a global propensity
Mohammad Aldiabat1,2, Ali Osman3, Malek Ayoub3
1Department of Medicine, Washington University in St Louis, St. Louis, Missouri, USA Mohameddiabat88@gmail.com.
Objectives:
To evaluate the association between metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic-associated steatohepatitis (MASH), and the risk of colorectal cancer (CRC) and benign colorectal neoplasms (BCN), and to explore whether liver fibrosis/cirrhosis modifies these associations.
Design:
Retrospective cohort study with 1:1 propensity score matching.
Setting:
Global, multicentre real-world analysis using deidentified electronic health records from over 130 healthcare organisations in the TriNetX Global Collaborative Network.
Participants:
Hospitalised adults aged 45-75 years between October 2019 and October 2024. Patients with prior diagnoses of colorectal neoplasia or other chronic liver diseases were excluded. Final matched cohorts included 138 902 MASLD and non-MASLD patients, 3715 MASH and non-MASH patients, and 1312 MASH patients with and without fibrosis.
Primary And Secondary Outcome Measures:
Primary outcomes: Incidence of CRC and BCN.
Secondary Outcome:
Combined incidence of CRC and BCN. Outcomes were assessed with and without controlling for metabolic risk factors using Cox proportional hazards models.
Results:
MASLD was associated with increased risks of CRC (HR 2.71, 95% CI 2.29 to 3.20) and BCN (HR 2.50, 95% CI 2.38 to 2.63), both p<0.001. MASH patients had a 5-fold higher risk of CRC (HR 5.03, 95% CI 1.43 to 17.72, p=0.005) and nearly 2-fold risk of BCN (HR 1.91, 95% CI 1.38 to 2.67, p<0.001). No significant differences in CRC or BCN risk were observed between MASH patients with versus without fibrosis/cirrhosis.
Conclusions:
MASLD and MASH are independent risk factors for CRC and BCN, irrespective of metabolic comorbidities. Fibrosis/cirrhosis does not significantly influence CRC risk. These findings support the need to revisit CRC screening guidelines for patients with MASLD/MASH. Further prospective studies are warranted to explore underlying mechanisms and evaluate preventative interventions.
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