Prevention of NAFLD-associated HCC: Role of lifestyle and chemoprevention

In many countries worldwide, the burden of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing and preventive strategies are needed to counteract this trend. This review provides an overview of the evidence on preventive strategies in NAFLD-associated HCC. We considered the impact of lifestyle factors such as weight loss, physical activity, smoking, dietary patterns and food items, including coffee and alcohol, on both HCC and NAFLD/NASH. Furthermore, evidence on chemopreventive treatments, including aspirin, anti-diabetic treatments and statins is summarized. The role of adjuvant therapies considered for tertiary prevention of HCC is briefly reviewed.