Cited by 773Liver Disease Diagnosis and TreatmentHepatocellular Carcinoma Treatment and PrognosisAlcohol Consumption and Health Effects

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Association Between Nonalcoholic Fatty Liver Disease and Risk for Hepatocellular Cancer, Based on Systematic Review

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White, Donna L., Kanwal, Fasiha, El–Serag, Hashem B.·2012·Clinical Gastroenterology and Hepatology

DOI 10.1016/j.cgh.2012.10.001PMC PMC3501546

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Abstract

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) has been implicated as a cause of hepatocellular carcinoma (HCC). We performed a systematic review of epidemiology studies to confirm the association between these disorders. METHODS: We searched PubMed for original reports published from January 1992 to December 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 (eg, cohort studies) or indirect evidence (eg, case-control, cross-sectional, or case-series studies) for an association. We analyzed data from a total of 17 cohort studies (3 population based, 9 clinic based [6 limited to patients with cirrhosis], and 5 natural history), 18 case-control and cross-sectional studies, and 26 case series. RESULTS: NAFLD or NASH cohorts with few or no cases of cirrhosis cases had a minimal risk for HCC (cumulative HCC mortality of 0%-3% for study periods up to 20 y). Cohorts with NASH and cirrhosis had a consistently higher risk (cumulative incidence ranging from 2.4% over 7 y to 12.8% over 3 y). However, the risk for HCC was substantially lower in these cohorts than for cohorts with hepatitis C-related cirrhosis. Factors that increased risk among cohorts with NASH and cirrhosis could not be determined, because most studies were not sufficiently powered for multivariate analysis. CONCLUSIONS: 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 HCC; risk seems to be limited to individuals with cirrhosis.

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Authors: White, D. L., Kanwal, F., & El–Serag, H. B.
Affiliations: Michael E. DeBakey VA Medical Center (US)
Corresponding author: White, Donna L.
ORCID: White, Donna L.
Kanwal, Fasiha
Venue: Clinical Gastroenterology and Hepatology
Publisher: Elsevier BV
Published: 2012-12
Volume: 10
Issue: 12
Pages: 1342-1359.e2
ISSN: 1542-3565 (ISSN-L)
DOI: 10.1016/j.cgh.2012.10.001
PMC: PMC3501546
OpenAlex: W1975567145
Cited by: 766
References: 73
Citations by year: 2026: 16 · 2025: 26 · 2024: 39 · 2023: 49 · 2022: 61 · 2021: 71 · 2020: 68 · 2019: 64 · 2018: 76 · 2017: 73 · 2016: 54 · 2015: 58 · 2014: 54 · 2013: 56
FWCI: 6.70
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Gastroenterology and Hepatology (publishedVersion, cc-by)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (HFP90-020, DK56338)
National Institute of Diabetes and Digestive and Kidney Diseases (DK56338, K24DK078154, K24 DK081736-01, K01 DK078154-03, K01DK081736, P30DK056338)
Topics: Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords: non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, hepatocellular carcinoma, liver cirrhosis, cryptogenic cirrhosis, cancer risk, HCC mortality
MeSH terms: Fatty Liver, Humans, Liver Neoplasms, Risk Assessment, Non-alcoholic Fatty Liver Disease

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Association Between Nonalcoholic Fatty Liver Disease and Risk for Hepatocellular Cancer, Based on Systematic Review

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