Nonalcoholic fatty liver disease without cirrhosis appears to be a significant contributor to the rise in the incidence of HCC [hepatocellular carcinoma, also known as liver cancer] in the past two decades, according to a study from Dr. Rubayat Rahman said at the annual meeting of the American Association for the Study of Liver Diseases. 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 report showed cirrhosis was not present in the 36% of HCC cases, of those 6% had simple steatosis though the 64% of HCC cases had cirrhosis. Besides, the annual growth of NAFLD-related cases of HCC without cirrhosis outpaced those with cirrhosis.
Dr. Guadalupe Garcia-Tsao from School of Medicine, Yale University commented this finding was scary, as NAFLD is the most common liver disease, which is closely related to obesity. Therefore, the research indicated that with popularity of obesity, more people will not only get liver cirrhosis and liver disease and even liver cancer.
As NAFLD is closely related to obesity and it increased with popularity of obesity, Dr. Rahman said but if calling NAFLD as a risk factor for cancer, we still knew little how it play a role. To figure out it, Rahman and her team did a retrospective analysis on medical data from 1993 to 2007, covering 17,895 in the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database. The number of cases of NAFLD-related HCC without cirrhosis was at least 65.
Of those, 2,863 (16%) had only NAFLD without any other risk factors or etiologies for HCC. At 16%, NAFLD was third most common risk factor for HCC after infection (44%) and alcoholic diseases (19%) – 21% were other causes. In addition, 1,832 (64%) of HCC cases had cirrhosis while 36% had no cirrhosis, of those, only 186 (6%) had simple steatosis.
The annual growth of NAFLD-related cases of HCC without cirrhosis outpaced those with cirrhosis. The average number of cases per year of NAFLD-related HCC without cirrhosis grew significantly from 51 in 1993-2000 to 88 in 2001-2007, compared with no change in cases with cirrhosis.
The overall change between NAFLD with cirrhosis and its incidence were significantly distinct (p < 0.01) while those without cirrhosis were not significantly different. Among the NAFLD HCC cases, 5-year survival was better (p < 0.001) in non cirrhotic than cirrhotic cases (22% vs. 17%).
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