NAFLD associated with a higher risk of liver cancer

December's issue of the Clinical Gastroenterology & Hepatology examines the association between nonalcoholic fatty liver disease and risk for hepatocellular cancer.

Nonalcoholic fatty liver disease (NAFLD) has been implicated as a cause of hepatocellular carcinoma.

Dr Donna White and colleagues from Texas, USA performed a systematic review of epidemiology studies to confirm the association between these disorders.

The research team searched PubMed for original reports published from 1992 to 2011 that evaluated the association between NAFLD, nonalcoholic steatohepatitis (NASH), cryptogenic cirrhosis presumed to be NASH-related, and the risk of HCC.

Studies were categorized as offering potential direct evidence or indirect evidence for an association.

The team analyzed data from a total of 17 cohort studies, 18 case-control and cross-sectional studies, and 26 case series.

Cohorts with NASH and cirrhosis had a consistently higher risk

Clinical Gastroenterology & Hepatology

NAFLD or NASH cohorts with few or no cases of cirrhosis cases had a minimal risk for hepatocellular carcinoma.

The researchers observed that cohorts with NASH and cirrhosis had a consistently higher risk.

However, the risk for hepatocellular carcinoma was substantially lower in these cohorts than for cohorts with hepatitis C–related cirrhosis.

The team could not determine factors that increased risk among cohorts with NASH and cirrhosis, because most studies were not sufficiently powered for multivariate analysis.

Dr White's team concluded, "This systematic review shows that despite several limitations, there is epidemiologic evidence to support an association between NAFLD or NASH and an increased risk of hepatocellular carcinoma."

"Risk seems to be limited to individuals with cirrhosis."