Objective:

To examine the association between metabolic dysfunction-associated steatotic liver disease (MASLD) status at baseline and follow-up with incident liver cancer, and to assess the prognostic value of changes in MASLD status.

Approach:

Key Findings:

• At baseline, 4,008 participants (33.1%) had MASLD.
• MASLD at period 1 was associated with a higher risk of incident liver cancer (aHR, 2.81; 95% CI, 1.20–6.58).
• MASLD at period 2 also showed a similar association with liver cancer risk (aHR, 2.61; 95% CI, 1.12–6.06).
• Trajectory analysis indicated that both MASLD → no MASLD (aHR, 4.00; 95% CI, 1.01–15.80) and MASLD → MASLD (aHR, 3.51; 95% CI, 1.31–9.44) were linked to higher liver cancer risk.

Interpretation:

The findings suggest that MASLD at either assessment is associated with increased liver cancer risk, and changes in MASLD status may provide important prognostic information.

Limitations:

• The study may not account for all confounding factors influencing liver cancer risk, such as lifestyle factors and comorbidities.
• The cohort is limited to participants from the UK Biobank, which may affect generalizability.

Conclusion:

Persistent MASLD and prior MASLD exposure may both carry prognostic importance for liver cancer risk.

Attribution Notice

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