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Lookup NU author(s): Dr Steven MassonORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 Fundación Clínica Médica Sur, A.C.Introduction and Objectives Alcohol-related liver disease (ALD) is a known contributor to non-hepatic cancers (NHC). We aimed to describe the incidence and predictors of NHC in patients with ALD. Materials and Methods The WALDO study is a multicenter cohort study of patients with histologically characterized ALD. Participants are followed from the time of liver biopsy and outcomes are captured from health records. The primary outcome was the incidence of the first NHC. Risk factors for NHC were presented as unadjusted and adjusted sub-distribution hazards (SDH) based on competing risk analysis. Statistical analyses were done in R. Results 694 patients were included. The median age was 51 years (IQR 43- 59), 428 (62 %) patients were male and 349 (50 %) had cirrhosis on biopsy. During a median follow-up of 4.9 years (IQR 1.3 – 9.6 years), 78 patients (11 %) with ALD developed NHC. The cumulative incidence of NHC in ALD was 2.4 % (1.4 – 3.9 %) over five years. The most common site of NHC was respiratory (17 cases, 22 % of NHC) and digestive tract (17 cases, 22 %) and cancers of the head and neck (13 cases, 17 %). On multivariable analysis, increasing age (SDH 1.03; CI 1.00-1.07; p=0.037), previous smoking (SDH 5.11; CI 1.91-13.66; p= 0.001) and current smoking (SDH 3.84; CI 1.50-9.84; p = 0.005) along with cirrhosis (SDH 2.14; CI 1.10 -4.13; p=0.024) were associated with a higher risk of NHC. Conclusions NHC’s are common in patients with biopsy-confirmed ArLD. Addressing risk factors for NHC’s should be encouraged during routine follow-up to reduce the incidence.
Author(s): Brahmania M, Hindi Z, Shi N, Arab JP, Rajoriya N, Aithal GP, Allison M, Hagstrom H, Likhitsup A, McCune A, Masson S, Forrrest E, Oien K, Reed B, Parker R, WALDO investigators
Publication type: Article
Publication status: Published
Journal: Annals of Hepatology
Year: 2026
Volume: 31
Issue: 1
Print publication date: 01/01/2026
Online publication date: 08/04/2025
Acceptance date: 24/02/2025
Date deposited: 06/01/2026
ISSN (print): 1665-2681
ISSN (electronic): 2659-5982
Publisher: Elsevier Espana S.L.U
URL: https://doi.org/10.1016/j.aohep.2025.101908
DOI: 10.1016/j.aohep.2025.101908
PubMed id: 40210112
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