Prevention of NAFLD-associated HCC: Role of lifestyle and chemoprevention

Abstract

In many countries worldwide, the burden of hepatocellular carcinoma (HCC) associated with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing. Preventive strategies are needed to counteract this trend. In this review, we provide an overview of the evidence on preventive strategies in NAFLD-associated HCC. We consider the impact of lifestyle factors such as weight loss, physical activity, smoking, dietary patterns and food items, including coffee and alcohol, on both HCC and NAFLD/NASH. Furthermore, evidence on chemopreventive treatments, including aspirin, antidiabetic treatments and statins is summarised. The role of adjuvant therapies for tertiary prevention of HCC is briefly reviewed.

Keywords: Alcohol; Aspirin; Coffee; Diet; Hepatocellular carcinoma; Lifestyle; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Physical activity; Prevention; Probiotics; Statins.