{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:30:22Z","timestamp":1780075822225,"version":"3.54.0"},"reference-count":64,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"8","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"publisher","award":["04\u20102022\u20103140"],"award-info":[{"award-number":["04\u20102022\u20103140"]}],"id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"publisher","award":["30\u20102022\u20100340"],"award-info":[{"award-number":["30\u20102022\u20100340"]}],"id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"publisher","award":["04\u20102022\u20103140"],"award-info":[{"award-number":["04\u20102022\u20103140"]}],"id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"publisher","award":["30\u20102022\u20100340"],"award-info":[{"award-number":["30\u20102022\u20100340"]}],"id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Commun"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although an association between metabolic dysfunction\u2010associated fatty liver disease (MAFLD) and cardiovascular disease or overall mortality has been reported, it is unclear whether there is an association between MAFLD and cancer incidence or mortality. We aimed to investigate the differential risk of all\u2010 and site\u2010specific cancer incidence and mortality according to MAFLD subgroups categorized by additional etiologies of liver disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using the Korean National Health Insurance Service database, we stratified the participants into three groups: (1) single\u2010etiology MAFLD (S\u2010MAFLD) or MAFLD of pure metabolic origin; (2) mixed\u2010etiology MAFLD (M\u2010MAFLD) or MAFLD with additional etiological factor(s) (i.e., concomitant liver diseases and\/or heavy alcohol consumption); and (3) non\u2010MAFLD. Hepatic steatosis and fibrosis were defined using the fatty liver index and the BARD score, respectively. Cox proportional hazards regression was performed to estimate the risk of cancer events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among the 9,718,182 participants, the prevalence of S\u2010MAFLD and M\u2010MAFLD was 29.2% and 6.7%, respectively. During the median 8.3 years of follow\u2010up, 510,330 (5.3%) individuals were newly diagnosed with cancer, and 122,774 (1.3%) cancer\u2010related deaths occurred among the entire cohort. Compared with the non\u2010MAFLD group, the risk of all\u2010cancer incidence and mortality was slightly higher among patients in the S\u2010MAFLD group (incidence, adjusted hazard ratio [aHR] = 1.03; 95% confidence interval [CI]: 1.02\u22121.04; mortality, aHR = 1.06; 95% CI: 1.04\u22121.08) and highest among patients with M\u2010MAFLD group (incidence, aHR = 1.31; 95% CI: 1.29\u22121.32; mortality, aHR = 1.45; 95% CI: 1.42\u22121.48, respectively). The M\u2010MAFLD with fibrosis group (BARD score \u2265 2) showed the highest relative risk of all\u2010cancer incidence (aHR = 1.38, 95% CI = 1.36\u20131.39), followed by the M\u2010MAFLD without fibrosis group (aHR = 1.09, 95% CI = 1.06\u20131.11). Similar trends were observed for cancer\u2010related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">MAFLD classification, by applying additional etiologies other than pure metabolic origin, can be used to identify a subgroup of patients with poor cancer\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cac2.12454","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:48:21Z","timestamp":1687222101000},"page":"863-876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Differential risk of 23 site\u2010specific incident cancers and cancer\u2010related mortality among patients with metabolic dysfunction\u2010associated fatty liver disease: a population\u2010based cohort study with 9.7 million Korean subjects"],"prefix":"10.34133","volume":"43","author":[{"given":"Goh Eun","family":"Chung","sequence":"first","affiliation":[{"name":"Seoul National University Hospital Healthcare System Gangnam Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-7977","authenticated-orcid":false,"given":"Su Jong","family":"Yu","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong\u2010Ju","family":"Yoo","sequence":"additional","affiliation":[{"name":"Soonchunhyang University Bucheon Hospital","place":["Bucheon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Cho","sequence":"additional","affiliation":[{"name":"National Cancer Center","place":["Goyang, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu\u2010na","family":"Lee","sequence":"additional","affiliation":[{"name":"Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8128-8920","authenticated-orcid":false,"given":"Dong Wook","family":"Shin","sequence":"additional","affiliation":[{"name":"Samsung Medical Center","place":["Seoul, Republic of Korea"]},{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Samsung Advanced Institute for Health Science","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung\u2010Hwan","family":"Yoon","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Soongsil University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-3189","authenticated-orcid":false,"given":"Eun Ju","family":"Cho","sequence":"additional","affiliation":[{"name":"Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"issue":"1","key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction\u2010associated fatty liver disease: An international expert consensus statement","volume":"73","author":"Eslam M","year":"2020","unstructured":"Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero\u2010Gomez M, et\u00a0al. 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