ObjectiveTo investigate the association between decline in intrinsic capacity (IC) and the risk of developing primary hepatic carcinoma (PHC), and to provide evidence for early identification and prevention of PHC. MethodsThis prospective cohort study included 347 874 participants without PHC at baseline from the UK Biobank. Following the World Health Organization framework, a composite IC score was constructed using 7 indicators across 4 domains: psychological, sensory, vitality, and locomotor function. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between IC decline score and incident PHC. ResultsDuring the follow-up period from 2006–2010 to 2022, with a median follow-up of 13.6 years, 801 incident PHC cases were identified. IC decline score showed a clear dose-response association [HR=1.18, 95%CI (1.11, 1.26)]. Compared with participants without IC decline, those with IC decline scores of 2, 3, and ≥4 had 35% [HR=1.35, 95%CI (1.10, 1.65)], 72% [HR=1.72, 95%CI (1.34, 2.20)], and 75% [HR=1.75, 95%CI (1.25, 2.45)] higher risks of PHC, respectively. Among individual indicators, slower walking speed [HR=1.33, 95%CI (1.07, 1.66)], lower grip strength [HR=1.38, 95%CI (1.18, 1.62)], and weight loss [HR=1.28, 95%CI (1.08, 1.54)] showed the strongest associations with PHC risk. ConclusionsDecline in IC is positively associated with the risk of PHC, demonstrating a clear dose-response relationship. Incorporating IC assessment into routine health management and screening strategies for high-risk populations may improve early risk stratification and inform targeted prevention strategies.
