Incidence of Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease : A Systematic Review, Meta-analysis, and Meta-regression
Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved..
BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) may be a risk factor for hepatocellular carcinoma (HCC), but the extent of this association still needs to be addressed. Pooled incidence rates of HCC across the disease spectrum of NAFLD have never been estimated by meta-analysis.
METHODS: In this systematic review, we searched Web of Science, Embase, PubMed, and the Cochrane Library from January 1, 1950 through July 30, 2020. We included studies reporting on HCC incidence in patients with NAFLD. The main outcomes were pooled HCC incidences in patients with NAFLD at distinct severity stages. Summary estimates were calculated with random-effects models. Sensitivity analyses and meta-regression analyses were carried out to address heterogeneity.
RESULTS: We included 18 studies involving 470,404 patients. In patients with NAFLD at a stage earlier than cirrhosis, the incidence rate of HCC was 0.03 per 100 person-years (95% confidence interval [CI], 0.01-0.07; I2 = 98%). In patients with cirrhosis, the incidence rate was 3.78 per 100 person-years (95% CI, 2.47-5.78; I2 = 93%). Patients with cirrhosis undergoing regular screening for HCC had an incidence rate of 4.62 per 100 person-years (95% CI, 2.77-7.72; I2 = 77%).
CONCLUSIONS: Patients with NAFLD-related cirrhosis have a risk of developing HCC similar to that reported for patients with cirrhosis from other etiologies. Evidence documenting the risk in patients with nonalcoholic steatohepatitis or simple steatosis is limited, but the incidence of HCC in these populations may lie below thresholds used to recommend a screening. Well-designed prospective studies in these subpopulations are needed. The protocol for this systematic review is registered in the Prospero database (registration number CRD42018092861).
| Errataetall: |
CommentIn: Gastroenterology. 2022 May;162(6):1772-1774. - PMID 35120916 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association - 20(2022), 2 vom: 01. Feb., Seite 283-292.e10 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Orci, Lorenzo A [VerfasserIn] |
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| Links: |
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| Themen: |
Hepatocellular Carcinoma |
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| Anmerkungen: |
Date Completed 15.03.2022 Date Revised 14.05.2022 published: Print-Electronic CommentIn: Gastroenterology. 2022 May;162(6):1772-1774. - PMID 35120916 Citation Status MEDLINE |
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| doi: |
10.1016/j.cgh.2021.05.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM325172498 |
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| 100 | 1 | |a Orci, Lorenzo A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incidence of Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease |b A Systematic Review, Meta-analysis, and Meta-regression |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 15.03.2022 | ||
| 500 | |a Date Revised 14.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Gastroenterology. 2022 May;162(6):1772-1774. - PMID 35120916 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) may be a risk factor for hepatocellular carcinoma (HCC), but the extent of this association still needs to be addressed. Pooled incidence rates of HCC across the disease spectrum of NAFLD have never been estimated by meta-analysis | ||
| 520 | |a METHODS: In this systematic review, we searched Web of Science, Embase, PubMed, and the Cochrane Library from January 1, 1950 through July 30, 2020. We included studies reporting on HCC incidence in patients with NAFLD. The main outcomes were pooled HCC incidences in patients with NAFLD at distinct severity stages. Summary estimates were calculated with random-effects models. Sensitivity analyses and meta-regression analyses were carried out to address heterogeneity | ||
| 520 | |a RESULTS: We included 18 studies involving 470,404 patients. In patients with NAFLD at a stage earlier than cirrhosis, the incidence rate of HCC was 0.03 per 100 person-years (95% confidence interval [CI], 0.01-0.07; I2 = 98%). In patients with cirrhosis, the incidence rate was 3.78 per 100 person-years (95% CI, 2.47-5.78; I2 = 93%). Patients with cirrhosis undergoing regular screening for HCC had an incidence rate of 4.62 per 100 person-years (95% CI, 2.77-7.72; I2 = 77%) | ||
| 520 | |a CONCLUSIONS: Patients with NAFLD-related cirrhosis have a risk of developing HCC similar to that reported for patients with cirrhosis from other etiologies. Evidence documenting the risk in patients with nonalcoholic steatohepatitis or simple steatosis is limited, but the incidence of HCC in these populations may lie below thresholds used to recommend a screening. Well-designed prospective studies in these subpopulations are needed. The protocol for this systematic review is registered in the Prospero database (registration number CRD42018092861) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Hepatocellular Carcinoma | |
| 650 | 4 | |a Incidence | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Nonalcoholic Fatty Liver Disease | |
| 700 | 1 | |a Sanduzzi-Zamparelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Caballol, Berta |e verfasserin |4 aut | |
| 700 | 1 | |a Sapena, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Colucci, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Torres, Ferran |e verfasserin |4 aut | |
| 700 | 1 | |a Bruix, Jordi |e verfasserin |4 aut | |
| 700 | 1 | |a Reig, María |e verfasserin |4 aut | |
| 700 | 1 | |a Toso, Christian |e verfasserin |4 aut | |
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