According to the MD Anderson Cancer Center at the University of Texas, MASH can lead to liver inflammation, fibrosis, and cirrhosis—each a known precursor to hepatocellular carcinoma, the most common type of liver cancer. Though the disease can remain silent in its early stages, regular screening and lifestyle changes can help prevent long-term complications.
Understanding MASLD and Its Link to Cancer
MASLD involves the accumulation of fat in the liver in people who consume little or no alcohol. While MASLD itself may not be immediately dangerous, around 25% of affected individuals may develop MASH. This progression brings inflammation and damage to liver cells, eventually causing fibrosis (scarring) and possibly cirrhosis. Internal medicine specialist Dr. Jessica Hwang explains that once fibrosis has developed, the damage is difficult to reverse and increases cancer risk due to long-term cellular injury and inflammation.
What makes this disease particularly risky is that even those without cirrhosis may still face elevated cancer risk if they have MASH, as chronic inflammation remains a driver of cellular changes in the liver.
Who Is Most at Risk?
Several groups of people are more susceptible to MASLD and its complications:
- Individuals who are overweight or obese, especially with abdominal fat
- Those with type 2 diabetes
- People with high cholesterol or triglycerides
- Individuals with high blood pressure
- Those with metabolic syndrome, defined by a combination of obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels
- People with a family history of liver disease
According to Dr. Hwang, the presence of these conditions not only raises the risk of MASLD but also increases the likelihood of progression to MASH and liver cancer.
Recognising the Signs
Fatty liver disease is often termed a “silent” condition. Most people experience no noticeable symptoms until the disease becomes advanced. However, there are some potential warning signs, such as:
- Ongoing fatigue
- Discomfort or pain in the upper right abdomen
- Elevated liver enzymes seen in routine blood tests
- Enlarged liver visible through imaging
- Unexplained weight loss in more advanced cases
Because symptoms can be minimal or entirely absent, early detection through blood tests, ultrasounds, or MRIs is especially important for people with risk factors.
How to Lower Your Risk
Experts emphasize that the condition is not only preventable but often reversible if caught early. Key preventive measures include:
- Maintaining a healthy weight: Losing just 5–10% of body weight can improve liver health.
- Eating a balanced diet: A diet rich in fruits, vegetables, legumes, whole grains, and lean proteins helps reduce fat buildup in the liver.
- Exercising regularly: At least 150 minutes of moderate activity or 75 minutes of intense exercise weekly is recommended.
- Improving sleep quality: Poor sleep can increase insulin resistance and weight gain, worsening liver health.
- Avoiding tobacco and limiting alcohol: These substances can further damage the liver and heighten cancer risk.
- Managing cholesterol and blood sugar: Through a combination of diet, medication, and physical activity.
Hydration and routine check-ups are also vital. If you belong to a high-risk group or have symptoms, speaking with your doctor about liver screening and new treatment options, including certain weight-loss medications, can be critical.
Fatty liver disease might start off as a minor health issue, but its potential to evolve into MASH and even liver cancer makes early intervention crucial. With rising cases globally, especially among those with poor dietary and exercise habits, the condition is increasingly viewed as a serious health threat. Fortunately, the path to better liver health lies largely in lifestyle choices.
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