Lipid-rich environment: a key role promoting carcinogenesis in obesity-related non-alcoholic fatty liver disease

The epidemic of obesity has led to increased risk of many types of cancer including hepatocellular carcinoma (HCC).1 HCC is the most frequent presentation of liver cancer, the fifth most common cancer in men worldwide and the seventh in women.2 Even though viral and alcohol-related liver diseases are main causes of HCC, non-alcoholic fatty liver disease (NAFLD) has become the most rapidly increasing cause during the last decade.1 Even more, HCC may also develop in the absence of liver cirrhosis, and the incidence in livers without fibrosis is higher in the metabolic syndrome and NAFLD.1 According to data from the Surveillance, Epidemiology and End Results registries (2004–2009), in the USA, NAFLD-driven HCC is associated with shorter survival time and more advanced tumour stage.3 Besides, although numerous drugs have been proposed, there is still no available treatment for most patients with HCC.

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