JMIR Publications

ABSTRACT

Background:

Non-alcoholic fatty liver disease (NAFLD) is commonly considered a precursor of liver as well as other types of cancer. An updated estimate of the global prevalence of NAFLD in association with liver and other cancers is required.

Objective:

To determine the prevalence of various cancers in NAFLD patients and the association between NAFLD with cancer.

Methods:

We searched PubMed, ProQuest, Scopus, and Web of Science from database inception to March 2022, to identify eligible studies reporting the prevalence of NAFLD and the risk of incident cancers amongst adult (age ≥18 years) individuals. Data from selected studies were extracted, and meta-analysis was performed using random-effects models to obtain pool prevalence with 95% CIs. The quality of the evidence was assessed through Newcastle Ottawa Scale (NOS).

Results:

We identified 11 studies that met our inclusion criteria, involving 222,523 adults and 3 types of cancer; hepatocellular carcinoma (HCC), breast and other types of extrahepatic cancer. Overall pool prevalence of NAFLD and cancer was 26.0% (95% CI: 16.0 – 35.0), while 25.0% of people had NAFLD and HCC (95% CI: 7.0 – 42.0). NAFLD and breast cancer had the highest prevalence out of the three forms of cancer, at 30.0% (95% CI: 14.0 – 45.0). While the pool prevalence for NAFLD and other cancer was 21.0% (95% CI: 12.0 – 31.0).

Conclusions:

The review suggests that people with NAFLD may be at an increased risk of cancer, that might not influence the liver but also another organ such as breast, and bile. The findings serve as important evidence for policymakers to evaluate and recommend measures to reduce the prevalence of NAFLD through lifestyle and environmental preventive approaches.