Blaske B, Ward M, Thandassery RB. Metabolic dysfunction-associated steatotic liver disease and the consequence of extra-hepatic malignancy. World J Hepatol 2026; 18(8): 124224 [DOI: 10.4254/wjh.124224]
Corresponding Author of This Article
Ragesh Babu Thandassery, MD, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, 4300 W 7th St, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
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Gastroenterology & Hepatology
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review-article
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Blaske B, Ward M, Thandassery RB. Metabolic dysfunction-associated steatotic liver disease and the consequence of extra-hepatic malignancy. World J Hepatol 2026; 18(8): 124224 [DOI: 10.4254/wjh.124224]
World J Hepatol. Aug 27, 2026; 18(8): 124224 Published online Aug 27, 2026. doi: 10.4254/wjh.124224
Metabolic dysfunction-associated steatotic liver disease and the consequence of extra-hepatic malignancy
Benjamin Blaske, Michael Ward, Ragesh Babu Thandassery
Benjamin Blaske, Michael Ward, Ragesh Babu Thandassery, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Author contributions: Blaske B and Ward M contributed to manuscript writing; Thandassery RB contributed to concept, manuscript editing, final approval.
AI contribution statement: No AI support was used.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Ragesh Babu Thandassery, MD, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, 4300 W 7th St, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
Received: June 9, 2026 Revised: July 9, 2026 Accepted: July 27, 2026 Published online: August 27, 2026 Processing time: 70 Days and 7.3 Hours
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver condition worldwide, affecting an estimated one-quarter to one-third of the global adult population. Once conceptualized primarily as a hepatic disorder, MASLD is now recognized as a systemic metabolic disease with broad extra-hepatic consequences. Among the most clinically significant of these is a rising body of evidence linking MASLD to an increased risk of malignancies outside the liver. This review synthesizes current evidence on extra-hepatic cancers in MASLD, organized into two categories: Gastrointestinal (GI)-related malignancies and non-GI malignancies. We discuss the shared oncogenic mechanisms underlying these associations, including insulin resistance, chronic inflammation, lipotoxicity, gut microbiome dysbiosis, and adipokine dysregulation. Emerging data demonstrates rising trends in extra-hepatic cancer burden in MASLD populations, with particular concern for young-onset disease and advanced hepatic fibrosis as risk-amplifying factors. We also address current diagnostic gaps and the clinical imperative for developing MASLD-specific cancer surveillance strategies.
Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) confers increased risk of extra-hepatic malignancies spanning multiple organ systems, beyond its well-recognized association with hepatocellular carcinoma. Shared oncogenic pathways which include insulin resistance, chronic systemic inflammation, lipotoxicity, and gut dysbiosis, link MASLD to both gastrointestinal (GI) cancers (colorectal, pancreatic, esophagogastric, biliary) and non-GI cancers (breast, gynecologic, thyroid, urinary, lung). Globally, the burden and prevalence of MASLD is rising, with young-onset disease and advanced fibrosis as key risk amplifiers. Dedicated cancer surveillance protocols for MASLD populations are urgently needed.
