Non-Alcoholic Steatohepatitis-Related Hepatocellular Carcinoma: A Growing Epidemic?

Within developed countries the incidence of hepatocellular carcinoma (HCC) has been progressively increasing despite diagnosing fewer new cases of cirrhosis linked to viral hepatitis and alcohol consumption. This increased incidence parallels the epidemic of morbid obesity and metabolic syndrome and may be secondary to non-alcoholic steatohepatitis (NASH)-related HCC. The aims of this chapter are to (1) define the natural history of non-alcoholic fatty liver disease/NASH, (2) discuss the relationship between cryptogenic cirrhosis and NASH-related cirrhosis, (3) compare the presentation and treatment of NASH-related HCC to viral hepatitis-related cirrhosis and (4) identify the genetic factors associated with NASH and NASH-related HCC.