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Hepatocellular Carcinoma in Obesity: Finding a Needle in the Haystack?
1Department of Medicine, VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. gbaffy@bwh.harvard.edu.
Advances in Experimental Medicine and Biology
|June 30, 2018
Summary
Obesity is linked to liver cancer (hepatocellular carcinoma, HCC), even without advanced liver disease. New biomarkers are needed for early detection in at-risk individuals.
Area of Science:
- Hepatology and Oncology
- Metabolic Syndrome and Cancer Research
Background:
- Obesity is a significant risk factor for hepatocellular carcinoma (HCC), a globally prevalent cancer with rising incidence in the US.
- Metabolic disorders, including type II diabetes and metabolic syndrome, drive nonalcoholic fatty liver disease (NAFLD) and hepatocarcinogenesis.
- HCC commonly arises in cirrhotic livers, but a subset develops in non-advanced NAFLD, posing surveillance challenges.
Purpose of the Study:
- To highlight the link between obesity, NAFLD, and HCC development, particularly in non-cirrhotic cases.
- To address the challenge of cost-efficient HCC surveillance in the large population with non-advanced NAFLD.
- To emphasize the need for enhanced risk stratification strategies and novel biomarkers for early detection.
Main Methods:
- Review of existing literature linking obesity, metabolic disorders, NAFLD, and HCC.
- Analysis of epidemiological data on HCC incidence in relation to obesity and NAFLD prevalence.
- Discussion of molecular mechanisms promoting hepatocarcinogenesis in obesity-associated liver disease.
Main Results:
- Obesity and associated metabolic conditions are key drivers of NAFLD and increase HCC risk.
- A significant proportion of HCC cases occur in patients without advanced liver cirrhosis.
- The prevalence of obesity-associated liver disease contributes substantially to the population-attributable fraction of HCC.
Conclusions:
- Enhanced risk stratification is crucial for HCC surveillance in individuals with non-advanced NAFLD.
- Development of clinical, laboratory, and genetic biomarkers is essential to meet this public health need.
- Addressing obesity-related liver disease is critical for reducing the burden of hepatocellular carcinoma.
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