Should we undertake surveillance for HCC in patients with MAFLD?

• Published in: Therapeutic advances in endocrinology and metabolism Vol. 14; p. 20420188231160389
• Main Authors: Norero, Blanca, Dufour, Jean-François
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2023; Sage Publications Ltd; SAGE Publishing
• Subjects: Cirrhosis; Cost effectiveness; Criteria; Fatty liver; Fibrosis; Hepatitis; Hepatocellular carcinoma; Liver; Liver cancer; Liver diseases; Metabolic disorders; Metabolic syndrome; Metabolism; Mortality; New Insights in MAFLD; Public health; Questions; Surveillance; Tumors; Hepatocellular carcinoma; surveillance; fatty liver disease
• ISSN: 2042-0188; 2042-0196
• DOI: 10.1177/20420188231160389

Over the last decade, metabolic-associated fatty liver disease (MAFLD) has become an important public health issue worldwide. In many countries, MAFLD has become the most common cause of chronic liver disease. On the contrary, hepatocellular carcinoma (HCC) mortality is rising. Liver tumors have become the third cause of cancer mortality worldwide. HCC is the most frequent liver tumor. While the burden of HCC related to viral hepatitis is declining, the prevalence of MAFLD-related HCC is rising rapidly. Classical screening criteria for HCC consider cirrhotic, advanced fibrosis, and viral hepatitis patients. Metabolic syndrome with liver involvement or MAFLD is associated with a higher risk of HCC development, even in the absence of cirrhosis. The question about the cost effectiveness of surveillance for HCC in MAFLD is yet not fully answered. There are no guidelines that address the question of when to start or how to define the population who can benefit of surveillance for HCC in MAFLD patients. This review aims to revise the evidence of HCC development in MAFLD. It hopes to be a step closer to defining screening criteria for HCC in MAFLD.