Examining liver cancer linked to obesity: An exploratory analysis
Liver cancer, specifically hepatocellular carcinoma (HCC), is a significant health concern, and a growing number of cases are associated with nonalcoholic fatty liver disease (NAFLD) and its more severe form, nonalcoholic steatohepatitis (NASH, now often called metabolic dysfunction-associated steatohepatitis or MASH).
The common causes and risk factors for these liver conditions primarily relate to metabolic dysfunction and its consequences. Key risk factors include obesity, especially excess abdominal fat, type 2 diabetes mellitus (T2DM) and glucose intolerance, metabolic syndrome, dyslipidemia (abnormal cholesterol and lipid levels), chronic inflammation of the liver due to fat accumulation leading to liver cell damage (steatohepatitis), and the progression of NAFLD to fibrosis, cirrhosis, and eventually liver cancer.
NAFLD begins with fat buildup in liver cells, unrelated to alcohol consumption. If this fat accumulation causes liver inflammation and injury (NASH/MASH), it can result in scarring (fibrosis), progressing to cirrhosis. Cirrhosis significantly increases the risk of liver cancer.
NAFLD/NASH-related liver cancer may be harder to detect early because symptoms develop insidiously. People with obesity, T2DM, and metabolic syndrome not only have increased risk of developing liver cancer but may also respond less favorably to treatment.
Doctors and healthcare professionals recommend regular ultrasounds for people with NASH to test for liver cancer. A doctor can also monitor liver enzyme levels and check for other signs of liver damage during regular checkups. If a person develops jaundice, feels pain in their upper right abdomen, or has low energy or fatigue, they should consider consulting a doctor.
Preventing liver disease can significantly reduce a person's risk of liver cancer. Some prevention strategies include eating a nutritious, balanced diet, avoiding very high fat foods, remaining physically active, and managing any health conditions. Losing 3-5% of body weight may improve symptoms of NAFLD, while losing up to 10% of body weight may improve NASH symptoms.
It's important to note that no specific medication has been approved for the treatment of NASH or NAFLD. However, a doctor will likely recommend exercise, lower-fat foods, and management of other risk factors such as high blood pressure and diabetes for NAFLD and NASH treatment.
Hepatocellular carcinoma (HCC) is the type of liver cancer that fatty liver cancer refers to, and is the fifth most common cancer worldwide. Liver disease is the leading cause of HCC.
In conclusion, the metabolic factors that cause fat build-up and inflammation in the liver—mainly obesity, insulin resistance, type 2 diabetes, and metabolic syndrome—are the major drivers of liver cancer risk in NAFLD and NASH. Therefore, it's crucial for people with risk factors for fatty liver, such as diabetes, abdominal obesity, obesity, metabolic syndrome, or heart disease, to see a doctor regularly.
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