Fatty liver disease can increase your risk of liver cancer or other types of cancer, including colorectal cancer. Many people with fatty liver disease also have other risk factors for cancer, such as obesity.

Fatty liver disease is the buildup of fat in your liver. The main forms are:

  • Non-alcohol-related fatty liver disease (NAFLD): fat buildup that isn’t related to high consumption of alcohol
  • Alcohol-related fatty liver disease (AFLD): fat buildup that is related to high alcohol consumption

Fatty liver disease is associated with a higher risk of liver cancer and some other types of cancer, including colorectal cancer. The connection may partially be due to changes in your liver and partially due to shared risk factors.

Here, we take a deeper look at the connection between fatty liver disease and cancer.

NAFLD occurs in up to 90% of people with obesity. It can progress to a more severe condition called non-alcohol-related steatohepatitis (NASH), which involves liver inflammation and damage.

NASH is associated with an increased risk of:

AFLD is caused by chronically high consumption of alcohol. It’s also highly associated with the development of cirrhosis and liver cancer.

Why might fatty liver disease increase liver cancer risk?

The buildup of fat in your liver can affect your liver’s ability to protect itself from toxic substances that reach it from your intestines through your portal vein. These substances can cause inflammation in your liver, leading to scarring.

Scarring of your liver — which is known as cirrhosis — is the top risk factor for the development of HCC. Chronic liver inflammation may be the main reason cirrhosis increases the risk of HCC.

How common is liver cancer in people with fatty liver disease?

In a large Swedish study published in 2022, researchers found that the risk of HCC in people with NAFLD was 12.18 times higher than in people in the general population. Additionally, people with NAFLD had a 1.22 times higher risk of developing any cancer.

In a 2023 study using data from the South Korean National Health Insurance Service, researchers found that the risk of liver cancer was 2.34 times higher in men with AFLD and 2.60 times higher in women with AFLD than in people without AFLD.

Fatty liver disease and other cancers

In a 2023 study, researchers found that NAFLD was associated with an increased overall risk of cancer and that the risk was greater with earlier onset of NAFLD. The risk of cancer was 1.52 times higher for people who developed NAFLD at 45 years old or younger.

In the Swedish study, researchers found that people with NAFLD were also at an increased risk of:

In the 2023 study using data from South Korea, researchers found that people with AFLD were at an increased risk of the following 10 types of cancer:

Symptoms of liver cancer can include:

It’s important to get medical attention if you develop any potential symptoms of liver cancer. The United Kingdom’s National Health Service recommends seeing a doctor if you have:

  • a lump in your abdomen
  • unexplained weight loss
  • symptoms of liver cancer that don’t get better after 2 weeks or get worse
Medical emergency

It’s important to get emergency medical attention if you develop jaundice or if you’ve been vomiting for more than 2 days.

Tests for liver cancer include:

Treatment for liver cancer can include:

In some cases, the buildup of fat in your liver can mimic liver cancer. Usually, this buildup occurs throughout the liver, but sometimes it can create concentrated tumors that mimic liver cancer on imaging scans.

Can fatty liver look like cancer on a CT scan or ultrasound?

In a 2023 case study, researchers reported a case of a woman with fatty liver deposits that couldn’t be differentiated from liver cancer with ultrasound, CT, and MRI scans. A biopsy was necessary to confirm the diagnosis.

Can cancer be mistaken for fatty liver?

Healthcare professionals can’t always tell the difference between liver cancer and fatty liver disease on imaging tests such as ultrasound. In these cases, a biopsy and blood tests may be necessary.

The most important treatment for AFLD is stopping alcohol consumption. If you completely avoid alcohol, at least some liver damage may be reversible.

NAFLD may be reversible with lifestyle changes such as:

  • exercising more
  • eating a balanced diet
  • losing weight if you have overweight or obesity

A doctor may also recommend medications to lower your cholesterol and triglyceride levels to help manage NAFLD.

Fatty liver disease is often considered a silent disease since it usually doesn’t cause symptoms until it becomes advanced. You might be able to reverse some liver damage by stopping alcohol consumption if you have AFLD or improving your diet and exercising more if you have NAFLD.