Excess body weight and the risk of primary liver cancer: an updated meta-analysis of prospective studies
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Aims To provide a quantitative assessment of the association between excess body weight (EBW) and the risk of primary liver cancer (PLC), we performed an updated meta-analysis of prospective observational studies.Methods We searched PUBMED and EMBASE for studies of body mass index and the risk of PLC published through 15 th September 2011. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model. The meta-regression and stratified methods were used to examine heterogeneity across studies.Results A total of 26 prospective studies, including 25,337 PLC cases, were included in this analysis. Overall, excess body weight (EBW: body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) were associated with an increased risk of PLC, with significant heterogeneity (EBW: SRRs 1.48, 95% CIs 1.31-1.67, P(h)<0.001, I2=83.6%; Obesity: SRRs 1.83, 95% CIs 1.59-2.11, P(h)<0.001, I2=75.0%). Subgroup analyses revealed that the positive associations were independent of geographic locations, alcohol consumption, history of diabetes or infections with hepatitis B (HBV) and/or hepatitis C virus (HCV). Obese males had a higher risk of PLC than obese females did (P=0.027). A stronger risk of PLC with EBW was observed for patients with HCV (but not HBV) infection or cirrhosis compared with the general population.Conclusions Findings from this meta-analysis strongly support that EBW or obesity is associated with an increased risk of PLC in both males and females.
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Factors associated with a higher risk of HCC occurrence in MASLD include presence and duration of T2D, obesity or both, older age, concurrent alcohol intake and/or smoking, FIB-4 > 3.25, and LSM > 10 kPa and increasing change in LSM.
“Table 8. Factors associated with a higher risk of HCC occurrence in MASLD.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [531]
The Quantitative data synthesis section reports an association between obesity and primary liver cancer, and the Discussion describes a possible NAFLD–HCC pathway. The analysis does not establish this list of risk factors specifically for people with MASLD; in particular, it does not support the stated diabetes-duration, FIB-4, or liver-stiffness thresholds or changes. (LLM, conf=0.89)
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References 64 · Cited by 248
- Authors
- Chen, Y., Wang, X., Wang, J., Yan, Z., & Luo, J.
- Affiliations
- Shanghai Medical College of Fudan University (CN)
- Corresponding author
- Wang, Xiaolin
- Venue
- European Journal of Cancer
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 48
- Issue
- 14
- Pages
- 2137-2145
- ISSN
- 0959-8049 (ISSN-L)
- OpenAlex
- W2145619783
- Cited by
- 248
- References
- 64
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 25 · 2023: 15 · 2022: 23 · 2021: 28 · 2020: 22 · 2019: 23 · 2018: 15 · 2017: 21 · 2016: 15 · 2015: 19 · 2014: 12 · 2013: 11 · 2012: 3
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Keywords
- overweight, obesity, primary liver cancer, hepatocellular carcinoma, body mass index, cancer risk factors, hepatitis C virus, hepatitis B virus, liver cirrhosis, sex differences in cancer risk
- MeSH terms
- Asia, Body Weight, Europe, Female, Humans, Liver Neoplasms, Male, Obesity, Prospective Studies, Risk Factors, United States, Body Mass Index, Risk Assessment, Overweight
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