AsianScientist (Aug. 7, 2011) – Researchers at The Chinese University of Hong Kong (CUHK) have found a close link between non-alcoholic fatty liver disease (NAFLD) and colorectal polyps, especially in patients between the ages of 40 and 70, and recommend earlier polyp-screening in this group.
Non-alcoholic fatty liver disease is one of the most common chronic liver diseases worldwide, and the condition affects one in four adults in Hong Kong.
Simple steatosis, or fatty degeneration, is the benign and inactive form of NAFLD.
The active form is called non-alcoholic steatohepatitis (NASH), and is associated with disease progression. In the long term, it can result in cirrhosis and liver cancer. Some risk factors for NAFLD and NASH include obesity, diabetes and systemic inflammation, all of which are related to the development of cancer. Epidemiological studies reveal that the mortality from cancer among patients with fatty liver is on the rise.
From 2008 to 2010, investigators from the Center for Liver Health at The Chinese University of Hong Kong (CUHK) screened for polyps using colonoscopy in 380 local citizens aged 40-70 years. The study subjects were healthy volunteers from the general community and hospital patients.
Overall, NAFLD patients were more likely to have colorectal polyps which tended to be more advanced. These patients were also more likely to have polyps in right-sided colon, which can only be examined by colonoscopy but not sigmoidoscopy which is more commonly used.
In addition, among 135 NAFLD patients whose disease severity was assessed by liver biopsy, those with NASH were more likely to have colorectal polyps and advanced polyps, indicating that the severity of NAFLD is associated with the risk of colorectal polyps.
According to data from the Center for Health Protection, colorectal cancer is the second most common cancer in Hong Kong, accounting for 16 percent of all new cancer cases in 2008.
It is also one of the most preventable cancers. Colorectal polyps are benign before they transform into cancer, and many cancer deaths can potentially be prevented if they are recognized and removed early.
Screening for colonic polyps in average risk individuals is recommended by most international guidelines starting at the age of 50. However, in view of these findings, CUHK researchers recommend that NAFLD patients receive colonoscopic screening starting from the age of 40.
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Source: The Chinese University of Hong Kong.
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