Nonalcoholic Fatty Liver Disease (NAFLD) and Hepatocellular Carcinoma: How Common?

Abstract

Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause of chronic liver disease in Western countries. NAFLD can progress to cirrhosis and its related complications, including hepatocellular carcinoma (HCC). Review of available evidence suggests an increased risk of HCC among patients with NAFLD-related cirrhosis, although this risk is smaller than risk of HCC among patients with viral hepatitis-related cirrhosis. Preliminary evidence suggests that a proportion of NAFLD-related HCC could develop in the absence of advanced liver disease or cirrhosis. NAFLD-related HCC is expected to increase, given the increasing prevalence of NAFLD; but this increase is not yet evident. Risk factors for HCC in NAFLD include older age, coexisting obesity or diabetes, high hepatic iron, and the presence of cirrhosis.