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September 21, 2020
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Women more likely to have noncirrhotic HCC, underlying NAFLD

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Compared with men, women had a significantly higher frequency of underlying nonalcoholic fatty liver disease and noncirrhotic hepatocellular carcinoma, according to data published in the American Journal of Gastroenterology.

“Women presented with less-advanced HCC and had a greater overall survival,” Meaghan Phipps, MD, from the department of medicine, division of digestive and liver diseases at Columbia University Irving Medical Center in New York, and colleagues wrote.

Phipps and colleagues identified 5,327 patients with HCC from January 2000 to June 2014 from five centers; 1,203 of these patients were women. Investigators collected clinical information, tumor characteristics and survival data. They used published criteria to assess the presence of underlying cirrhosis.

Results showed women had a significantly higher frequency of NAFLD (23% vs. 12%). Further, women had a lower frequency of alcoholic liver disease compared with men (5% vs. 15%). Women had a significantly higher proportion of noncirrhotic HCC (17% vs 10%; P < 0.0001).

“Women had less-advanced HCC at presentation by tumor, node, metastasis staging (P < 0.0001) and a higher proportion within Milan criteria (39% vs 35%; P = .002),” the researchers wrote.

Women had greater overall survival than men (2.5 years vs. 2.2 years; P = .0031).

“Focusing on the high prevalence of NAFLD in women who develop HCC despite similar rates of traditionally associated risk factors and comorbidities will be important for better characterizing their specific risk, especially given the associated high rates of noncirrhotic HCC within this group,” the researchers wrote.