Nonalcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma: The Next Threat after Viral Hepatitis

For many years, we have faced the complications of viral hepatitis and alcohol-related liver diseases such as cirrhosis, decompensation, portal hypertension, and hepatocellular carcinoma (HCC). Recently, we have seen a dynamic change in the field of hepatology. With the significant achievements in eradicating the hepatitis C virus by direct-acting antiviral agents and the rising epidemic of obesity, diabetes mellitus, and metabolic syndrome, there is a paradigm shift in the leading cause of liver cirrhosis and cancer to nonalcoholic fatty liver disease (NAFLD). Current data highlight the rapidly rising incidence of NAFLD-related HCC worldwide and expose the unseen part of the iceberg. In this review, we aim to update knowledge about the pathogenesis of NAFLD-induced HCC, surveillance difficulties, and promising disease markers. Molecular biomarkers, for example, may become a promising cornerstone for risk-stratified surveillance, early detection, and treatment selection for NAFLD-related HCC. Physicians can offer personalized and tailor-made clinical decisions for this unique patient subgroup.

Automated summary

Over the years, the complications of viral hepatitis and alcohol-related liver diseases have been a major concern in hepatology. However, recent advancements in the field have revealed a paradigm shift towards nonalcoholic fatty liver disease (NAFLD) as the leading cause of liver cirrhosis and cancer. This review focuses on updating knowledge about the pathogenesis of NAFLD-induced hepatocellular carcinoma (HCC), surveillance challenges, and potential disease markers, such as molecular biomarkers, which may revolutionize risk stratification, early detection, and treatment selection for NAFLD-related HCC.