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Farrell et al. Hepatoma Res 2020;6:18 Hepatoma Research
DOI: 10.20517/2394-5079.2019.019

Review Open Access

Epidemiology of non-alcoholic fatty liver disease-
related hepatocellular carcinoma: a western

perspective

Ann Farrell , Marno Ryan , Jessica Howell 1,2,3
1,2
1,2
1 Department of Gastroenterology, St. Vincent’s Hospital Melbourne, Melbourne 3065, Australia.
2 Department of Medicine, The University of Melbourne, Melbourne 3010, Australia.
3 Disease elimination program, Burnet Institute, Melbourne 3004, Australia.

Correspondence to: Dr. Ann Farrell, Department of Gastroenterology, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia.
E-mail: ann.farrell@svha.org.au

How to cite this article: Farrell A, Ryan M, Howell J. Epidemiology of non-alcoholic fatty liver disease-related hepatocellular
carcinoma: a western perspective. Hepatoma Res 2020;6:18. http://dx.doi.org/10.20517/2394-5079.2019.019

Received: 14 Oct 2019 First Decision: 3 Feb 2020 Revised: 27 Feb 2020 Accepted: 9 Mar 2020 Published: 23 Apr 2020
Science Editor: Darrell Crawford Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Received: First Decision: Revised: Accepted: Published:
Abstract
Science Editor: Copy Editor: Production Editor: Jing Yu
Non-alcoholic fatty liver disease (NAFLD) is now the most common cause of liver disease worldwide, and represents
an increasingly important cause of hepatocellular carcinoma (HCC). As the prevalence of NAFLD has increased,
the burden of NAFLD-related HCC has been rising in parallel. This is particularly evident in Western countries,
where NAFLD is estimated to account for 10%-59% of all HCC. NAFLD-related HCC can occur in the presence or
absence of cirrhosis, and, while those with cirrhosis remain at the greatest risk, factors such as steatohepatitis, age,
genetic polymorphisms, type 2 diabetes mellitus and obesity also appear have an impact on the risk of developing
HCC in NAFLD. In this review, we present the epidemiology of NAFLD-related HCC from a Western perspective,
highlighting gaps in current knowledge and future directions for research in this field.

Keywords: Non-alcoholic fatty liver disease, steatohepatitis, cirrhosis, hepatocellular carcinoma, epidemiology

INTRODUCTION
Over the past two decades, non-alcoholic fatty liver disease (NAFLD) has rapidly become the most
[1]
common cause of liver disease worldwide, affecting approximately a quarter of the global population . It
is considered to be a hepatic end organ effect of the metabolic syndrome and its rise to prominence has

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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