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NAFLD linked to higher risk for HCC

The risk for hepatocellular carcinoma was higher among patients with nonalcoholic fatty liver disease, especially those with cirrhosis, compared with the general clinical population, according to a study published in Gastroenterology.

Additionally, the absolute risk for HCC was higher than the accepted thresholds for HCC surveillance among most patients with NAFLD-related cirrhosis.

“Our study shows that biochemically apparent NAFLD may be the most relevant condition in terms of HCC risk,” Fasiha Kanwal, MD, MSHS, wrote.

Kanwal and colleagues identified 296,707 patients with NAFLD and 296,707 matched controls with a mean age of 55.4 years. The prevalence of cirrhosis diagnoses among patients with NAFLD increased from 0.4% at baseline to 1.4% by study end.

A total of 545 patients between both cohorts had confirmed incident HCC during the study, 490 of whom had NAFLD. The annual HCC incidence rate was significantly higher among patients with NAFLD (0.21 per 1,000 person-years; 95% CI, 0.19-0.22) than the controls (0.02 per 1,000 person-years; 95% CI, 0.02-0.03).

In multivariable analyses, NAFLD correlated with a significantly higher risk for HCC after adjusting for race and features of metabolic syndrome (aHR = 7.62; 95% CI, 5.76-10.09).

By a factor of 1,000 person-years, HCC incidence rates were higher in men than women (0.22 vs. 0.4), patients older than 65 years than younger patients at NAFLD index (0.41 vs. 0.01-0.21), and Hispanics (0.29) than Whites (0.21) or African-Americans (0.12).

“Overall, we believe that our comprehensive evaluation and quantification of HCC risk for different patient subgroups is very useful to public health authorities and health plans that are trying to use similar data to manage patients with NAFLD,” the researchers wrote. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.