Commentary
Recent studies link NAFLD to an increased incidence of hepatocellular carcinoma (HCC) and extrahepatic cancers. However, prior studies were small or lacked liver histology, which remains the gold standard for staging NAFLD severity. TG Simon et al. (Harvard Medical School, Boston, USA) conducted a population-based cohort study of all adults with histologically defined NAFLD in Sweden from 1966 to 2016 (N=8,892) over a median of 13.8 years
Compared with controls, patients with biopsy proven NAFLD had significantly increased cancer incidence, due primarily to HCC, whereas the contribution of extrahepatic cancers was modest. Although HCC risk was highest with cirrhosis, substantial excess risk was also found with noncirrhotic fibrosis and comorbid diabetes.
