21 Jan 2026 • New data from two large cohorts showed that incidentally identified splenomegaly was a strong predictor of future hematologic malignancy and liver disease.

Individuals with extreme splenic enlargement faced the greatest danger, as spleen volumes above the 99th percentile were associated with more than an 11-fold higher risk of hematologic cancer (HR 11.1–11.8). Five-year cancer risk began to increase at spleen lengths of 130–139 mm or volumes of 400–499 mL and escalated substantially with further enlargement.

Among adults aged 70 years or older, a spleen length of at least 140 mm corresponded to a 5-year hematologic cancer risk of 23% in men and 12% in women. At spleen volumes of 500 mL or more, 5-year cancer risk reached 21%–46% in men and 18%–27% in women. Larger spleen volumes were also linked to markedly higher risks of cirrhosis and liver cancer, with five-year cirrhosis rates exceeding 10% in older adults.

These findings offer clinically useful size thresholds to help guide evaluation and follow-up of incidentally detected splenomegaly.

Source: JAMA Network | Read full story