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NASH and HCC

NASH and HCC

20 Aug 2021 17:00 17:10
(10 mins)
Fan Jian-Gao Speaker
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Nonalcoholic steatohepatitis (NASH) is the subtype of NAFLD that can progress to cirrhosis and HCC. Currently 25% of the global population have NAFLD, 10%-30% of them have NASH. The incidence of NASH is projected to increase by 56% in the next decade. The pooled prevalence of NASH in Asia was higher at 63.5% ascertained from biopsy-proven NAFLD patients. With the growing epidemics of obesity and T2DM, the prevalence of NAFLD/ NASH and risk of HCC will increase. NAFLD is thus the fastest growing cause of HCC in the world. According to the Global Burden of Disease study, HCC-related deaths in 2017 increased 16.0% than that in 2012 and 8% of HCC deaths were related to NAFLD, NAFLD is the most rapidly growing contributor to incident HCC. In Asia there is few data on NAFLD-HCC and is likely confounded by the higher prevalence of CHB. Actually, obesity, T2DM, and NAFLD can increase the risk of HCC in patients with and without CHB, and the incidence of NAFLD-related HCC is projected to increase dramatically by 2030. The available data suggest that 2% of all HCC in Japan was due to NAFLD, the incidence of HCC was 0.04% in 6508 Japanese with NAFLD during a median follow-up of 6 years. In South Korea, the proportion with NAFLD-related HCC rose from 3.8% in 2001–2005 to 12.2% in 2006–2010 in 329 patients. Moreover, the proportion of NASH as an underlying etiology for HCC in patients being listed for transplantation has increased over 7-fold in the USA and Europe. Interestingly, NAFLD-associated HCC can develop in patients with or without cirrhosis. In this lecture, I will discuss the global epidemiology, projections and risk factors for NAFLD-related HCC, and propose preventive strategies to tackle this growing problem.

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