代谢功能障碍相关的脂肪肝病 (MASLD) 在全世界范围内造成了巨大且不断增加的健康和经济负担。大量流行病学证据表明，MASLD 是一种多系统疾病，不仅与肝脏相关并发症有关，还与心脏代谢合并症和肝外癌症（主要是胃肠道 [GI] 癌症）的风险增加有关。胃肠道癌症占全球癌症发病率的四分之一和癌症相关死亡的三分之一。在这篇叙述性综述中，我们概述了以下方面的文献：(a) 关于 MASLD 中非肝癌胃肠道癌症风险的流行病学数据，(b) MASLD（以及与 MASLD 相关的因素）可能增加这种风险的推定机制风险，以及 (c) 可能有益于影响 MASLD 和肝外胃肠道癌症风险的药物疗法。 MASLD 可能通过多种潜在的病理生理学机制增加肝外胃肠道癌症风险。尽管还需要进一步研究，但目前的证据支持 MASLD 可能具有肝外致癌作用，无论肥胖和糖尿病状况如何，从而凸显了为 MASLD 患者量身定制癌症筛查的潜在作用。尽管文献中存在相互矛盾的数据，但阿司匹林、他汀类药物和二甲双胍似乎对胃肠道癌症具有一定的化学预防作用。版权所有 © 2024。由 Elsevier Inc. 出版。

Metabolic dysfunction-associated steatotic liver disease (MASLD) poses a significant and ever-increasing health and economic burden worldwide. Substantial epidemiological evidence shows that MASLD is a multisystem disease that is associated not only with liver-related complications but is also associated with an increased risk of developing cardiometabolic comorbidities and extrahepatic cancers (principally gastrointestinal [GI] cancers). GI cancers account for a quarter of the global cancer incidence and a third of cancer-related deaths. In this narrative review, we provide an overview of the literature on (a) the epidemiological data on the risk of non-liver GI cancers in MASLD, (b) the putative mechanisms by which MASLD (and factors linked with MASLD) may increase this risk, and (c) the possible pharmacotherapies beneficially affecting both MASLD and extrahepatic GI cancer risk. There are multiple potential pathophysiological mechanisms by which MASLD may increase extrahepatic GI cancer risk. Although further studies are needed, the current evidence supports a possible extrahepatic carcinogenic role for MASLD, regardless of obesity and diabetes status, thus highlighting the potential role of tailoring cancer screening for individuals with MASLD. Although there are conflicting data in the literature, aspirin, statins and metformin appear to exert some chemo-preventive effects against GI cancer.Copyright © 2024. Published by Elsevier Inc.