Fatty liver disease, including nonalcoholic fatty liver disease (NAFLD), is a risk factor for liver cancer. Fatty liver disease can progress to nonalcoholic steatohepatitis (NASH), a more serious type of fatty liver disease that causes inflammation and damage to the liver and can lead to cancer.

According to a 2019 study, 2.6% of people with NASH develop hepatocellular carcinoma, or cancer, annually. The risk is much higher when a person with NASH develops cirrhosis, which is a type of liver scarring.

NAFLD often responds well to lifestyle changes. Making lifestyle changes, such as diet, can also reduce the risk of cancer even when NAFLD progresses to NASH.

This article will explain what fatty liver cancer is, along with fatty liver disease, its symptoms, causes, treatment, and outlook.

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Fatty liver cancer is not a type of cancer. Instead, it is a term doctors give to a type of cancer that fatty liver disease can cause.

Fatty liver cancer can increase the risk of eventually developing hepatocellular carcinoma (HCC), a type of liver cancer. HCC is the most common type of liver cancer and the fifth most common cancer worldwide.

Liver disease is the leading cause of HCC. People with fatty liver disease may develop cirrhosis. The chronic inflammation of cirrhosis can then lead to cancer.

Fatty liver disease is a group of conditions that cause fat to accumulate in the liver. The most common type is nonalcoholic fatty liver disease (NAFLD). NAFLD does not usually cause symptoms, but it is a risk factor for developing more serious types of liver disease.

Obesity, metabolic syndrome, and type 2 diabetes increase the risk of NAFLD. The lifestyle factors that correlate with these diseases, such as a sedentary lifestyle and a high fat diet, also increase the risk of NAFLD.

NAFLD can progress to the more serious diagnosis of nonalcoholic steatohepatitis (NASH). NASH may lead to cirrhosis, which is scarring of the liver. Around 80–90% of people with cirrhosis eventually develop liver cancer.

Fatty liver disease does not usually cause noticeable symptoms. When it does, a person may experience fatigue or pain in the upper right portion of the abdomen, where the liver is.

People with NASH may not have symptoms either. When they do, they may notice the following:

  • pain in the upper right portion of the abdomen
  • acanthosis nigricans, a type of skin darkening around the neck and joints
  • loss of muscle
  • ascites, a swollen abdomen from liver disease
  • jaundice that may turn the eyes or skin yellowish

A person may also consider monitoring for fatty liver if they have risk factors such as:

Learn more about fatty liver disease.

A person should see a doctor regularly if they have risk factors for fatty liver. A doctor may do blood work to monitor liver enzyme levels and check for other signs of liver damage.

Fatty liver is often asymptomatic, meaning people need regular checkups to detect it. Some people may have symptoms or symptoms of another type of liver disease. A person might consider consulting a doctor if they:

  • develop jaundice, which may cause the eyes or skin to look yellow
  • feel pain in their upper right abdomen.
  • have low energy or fatigue or frequently feel sick.

Learn more about the symptoms of liver disease.

NAFLD develops when fat accumulates in the liver. Over time, this fat can damage the liver. The main risk factors for this fat accumulation include:

A sedentary lifestyle, high fat diet, and processed fatty foods are significant risk factors for NAFLD. These lifestyle factors can also contribute to obesity, which can also lead to NAFLD.

Learn more about a diet for fatty liver.

Lifestyle changes are the primary treatment for both NAFLD and NASH. Losing just 3–5% of body weight may improve symptoms of NAFLD, while losing up to 10% of body weight may improve NASH symptoms.

A doctor will likely recommend that a person exercise more and introduce lower-fat foods into their diet. Treatment for other risk factors, such as high blood pressure, is also important. A person might need blood pressure or cholesterol medication, as well as treatment for diabetes.

No medication has approval for the specific treatment of NASH or NAFLD, though researchers are testing several options.

Doctors and healthcare professionals recommend that people with NASH have regular ultrasounds to test for liver cancer.

The treatment for HCC may include:

The outlook is worse at each stage of liver disease. People with NAFLD have a higher risk of developing NASH if they do not make appropriate lifestyle changes.

Every year, 2.6% of people with NASH develop liver cancer. If a person develops cirrhosis, their lifetime risk of HCC is 80–90%.

The overall 5-year survival rate for a person with HCC is less than 20%. The prognosis is better with an earlier-stage tumor. A doctor is more likely to detect an early-stage tumor in people at high risk who receive regular testing.

Although family history and genetics can increase the risk of liver disease and liver cancer, lifestyle factors play a major role in NAFLD, NASH, and HCC. Some prevention strategies that may help include:

  • eating a nutritious, balanced diet
  • avoiding very high fat foods
  • remaining physically active
  • taking proactive steps to manage any health conditions a person has

Fatty liver includes NAFLD and NASH. Lifestyle changes can help reduce the risk of both conditions, sometimes reverse the conditions, and also reduce the risk of liver cancer.

Liver disease, including NAFLD, is the leading risk factor for liver cancer. Preventing liver disease can significantly reduce a person’s risk of liver cancer. In people already at high risk, ongoing monitoring can detect the cancer in its early stages.

People at risk of liver disease and liver cancer should discuss treatment and management options with a doctor.