Non-alcoholic fatty liver disease-related hepatocellular carcinoma: a sleeping tiger in the Asia Pacific

The epidemiology of hepatocellular carcinoma (HCC) in the Asia Pacific will undergo significant change over the next few decades as the prevalence of viral hepatitis declines and the burden of metabolic diseases increases. As the Asia Pacific embraces continued affluence, obesity and diabetes rates are burgeoning, becoming increasingly important to the incidence of HCC. Obesity and diabetes are established risk factors for HCC, either as substrates for non-alcoholic fatty liver disease (NAFLD) or as independent carcinogens themselves. This review summarises the epidemiological data on changing HCC trends in the Asia Pacific, particularly as it pertains to the emerging problem of NAFLD-related HCC.