Severe Fatty Liver Disease Associated With Liver Cancer

A study published in Gastroenterology found that the risk of hepatocellular cancer (HCC) is higher in patients with severe non-alcoholic fatty liver disease (NAFLD) than the general population. 

The retrospective, cohort study included 296,707 patients from 130 facilities in the Veterans Health Administration who were diagnosed with NAFLD between January 1, 2004, and December 31, 2008. Researchers also identified a gender- and age-matched controls without NAFLD (n= 296,707). Patients were tracked over an average of 11 years. 

Risk of hepatocellular cancer > in NAFLD patients general population. Most HCC cases in NAFLD developed in patients with cirrhosis. Absolute risk of HCC was higher than the accepted thresholds for HCC surveillance. https://t.co/up6PmvlJi3 @TrueHealthDiag

— Thomas Dayspring (@Drlipid) September 5, 2018

Over 1 year, there was approximately one case of liver cancer for every 50,000 patients among those with healthy livers. However, in the NAFLD cohort, there was approximately one case of liver cancer for every 5,000 people.  

During follow-up, 490 patients with NAFLD developed HCC. The incidence of HCC was significantly higher among NAFLD patients compared with the control cohort (hazard ratio = 7.62; 95% CI, 5.76-10.09). Among patients with NAFLD, those with cirrhosis had the highest annual incidence of HCC, and the HCC risk ranged from 1.6 to 23.7 per 1,000 PY based on other demographic characteristics.  

Isn’t this one of the several forms of high mortality obesity linked cancers that is rising in the era of #PrecisionMedicine? https://t.co/2bdYPQONKY

— Michael Joyner (@DrMJoyner) August 28, 2018

The study also found higher rates of HCC in men and older patients, and lower rates in women and patients <45 years of age. The risk of HCC was the highest among older Hispanics with cirrhosis.  

The findings suggest that people with NAFLD and cirrhosis should be monitored for HCC, according to the authors. 

Liver cancer mortality is increasing in developed countries, including the United States.  

The FDA approved lenvatinib for liver cancer. 

Source: Gastroenterology