What is it about?

We looked at historical data from patients who have been diagnosed with hepatitis C (HCV) and non-alcoholic fatty liver disease (NAFLD). Their liver stiffness, as measured by a test called transient elastography, was stratified into 4 categories based on the value. Higher values, correlating with increasing stiffness, was associated with a higher rate of liver cancer in both HCV and NAFLD.

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Why is it important?

European guidelines and those from the American Association for the Study of Liver Disease differ with the latter recommending screening for liver cancer only in those who have documented cirrhosis. This paper sought to answer the question of whether those with stiff livers but without cirrhosis may also benefit from surveillance, as previously the risk in these patients was not well-documented. Further research is needed to determine the cut-off for level of stiffness above which patients would benefit from liver cancer surveillance.


This study helps providers further understand the risk of liver cancer in their patients who have clinically significant liver disease without necessarily having cirrhosis. This was previously understudied, but, now, these patients can be informed more fully and make decisions regarding pursuing screening.

Kyle Hoffman
Case Western Reserve University

Read the Original

This page is a summary of: Increasing liver stiffness is associated with higher incidence of hepatocellular carcinoma in hepatitis C infection and non-alcoholic fatty liver disease–A population-based study, PLoS ONE, January 2023, PLOS,
DOI: 10.1371/journal.pone.0280647.
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