Risk of Extrahepatic Cancer for Metabolic Dysfunction‐Associated Steatohepatitis ( <scp>MASH</scp> ) in the United States Medicare Population

This retrospective observational cohort study was conducted using 100% Medicare fee-for-service claims data (10/01/2015-12/31/2021) to characterise risk of incident extrahepatic cancer in patients with non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) and for patients with MASH who progressed to more advanced liver disease (compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, liver transplant). For patients with non-cirrhotic MASH, 5-year cumulative incidence was 3.1% for breast cancer, 2.8% for lymphoma/leukaemia, 2.6% for prostate cancer and 1.4% for lung cancer. The greatest hazard of cancer incidence was observed for bladder (hazard ratio [HR] = 2.36), kidney (HR = 2.15), liver (HR = 2.48) and stomach cancers (HR = 3.38; all p < 0.05), each relative to control individuals without MASH/metabolic dysfunction-associated steatotic liver disease. Additionally, patients who progressed to advanced liver disease experienced a significantly increased hazard of several extrahepatic cancers. This study provides some of the first evidence on the incidence and risk of extrahepatic cancer among patients with MASH in the United States.