Probably (Clin Gastroenterol Hepatol 2012; 10: 1342-59).
The authors of this study reviewed original reports between 1992-2011 and narrowed them to those with pertinent information regarding evidence of whether non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) contributed to a higher risk of hepatocellular carcinoma (HCC).
17 cohort studies, 18 case-control and cross-sectional studies, and 26 case series were identified.
- Cohorts with NASH and cirrhosis had a consistently higher risk of HCC; cumulative risk ranged from 2.4% over seven years to 12.8% over 3 years.
- Cohorts with few or no cases of cirrhosis had a minimal risk of HCC; cumulative risk of HCC mortality was 0-3% for study periods up to 20 years.
The results of patients with NASH and cirrhosis are in agreement with a recent presentation at AASLD meeting; however, there may be a small risk even in the absence of cirrhosis (Fatty Liver Disease Cited for Rise in Hepatocellular Carcinoma November 2012):
“Of 17,895 HCC cases in the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database, 2,863 (16%) had only NAFLD without any other risk factors or etiologies for HCC. The linked database covers 30% of the U.S. Medicare population. SEER itself contains data from 18 cancer registries covering 28% of the U.S. population.” In addition, “Cirrhosis was not present in 36% of the NAFLD-related HCC cases.” In the SEER database, the odds ratio for developing HCC with cirrhotic NAFLD was 16.5 compared with those with noncirrhotic NAFLD.
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