Is liver fibrosis a risk factor for gynecological cancers?

A recent study by Crudele et al. reported on the association between surrogate indices of liver fibrosis and risk of gynecological cancers among dysmetabolic women. To put this study in context, notions regarding sex dimorphism in nonalcoholic fatty liver disease (NAFLD) are discussed. Additionally, meta-analytic reviews regarding the risk of extrahepatic cancers are reviewed. Next, I discuss the relationship of metabolic dysfunction-associated fatty liver disease (MAFLD) with extrahepatic cancers, notably including the breast and cancers of the female reproductive systems in humans. The pathomechanisms potentially accounting for this association include genetics, deregulated sex hormones, chronic subclinical inflammatory state, dysmetabolic milieu, oxidative stress, gut dysbiosis, environmental pollution, and altered immune surveillance.