ROSH Gastrointestinal Practice Exam

Which organ is most likely to undergo malignant transformation due to chronic alcohol abuse?

1. Breast

2. Colorectal

3. Liver

4. Lung

The correct answer is: Liver

Chronic alcohol abuse has a well-established link to liver disease, particularly due to its role in the development of alcoholic liver disease, which can progress to conditions like alcoholic hepatitis, fibrosis, and eventually cirrhosis. The liver is particularly susceptible to damage from alcohol because it is the primary organ that metabolizes alcohol. The repeated cycle of liver cell injury and regeneration due to alcohol exposure can lead to mutations and ultimately to the development of hepatocellular carcinoma (HCC), a type of primary liver cancer. Several pathways contribute to this malignant transformation, including oxidative stress, inflammation, and increased levels of certain metabolites that can promote tumorigenesis. In contrast, while alcohol consumption can influence the risk of malignancies in other organs, such as the breast or gastrointestinal tract, the liver remains the most directly affected by chronic alcohol abuse in terms of cancer development. This makes the liver the organ that is most likely to undergo malignant transformation due to long-term alcohol abuse.