Non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of developing hepatocellular carcinoma (HCC), especially among those who have cirrhosis or advanced fibrosis, but 20–30% of cases of NAFLD-related HCC occur in the absence of advanced fibrosis. The prevalence of NAFLD-related HCC is increasing in most countries worldwide. There are few direct data to support or refute the efficacy or effectiveness of HCC surveillance in NAFLD or to guide its application. We use evidence on surveillance in other conditions and studies on the clinical course of patients with NAFLD to arrive at recommendations for rational approaches to HCC surveillance in this growing cohort of patients. We also outline gaps in research and practice, including opportunities to advance the field.

非酒精性脂肪性肝病 (NAFLD) 与发生肝细胞癌 (HCC) 的风险增加有关，尤其是在那些患有肝硬化或晚期纤维化的患者中，但 20-30% 的 NAFLD 相关 HCC 病例发生在没有肝细胞癌的情况下晚期纤维化。NAFLD 相关 HCC 的患病率在全球大多数国家都在增加。很少有直接数据支持或反驳 HCC 监测在 NAFLD 中的功效或有效性或指导其应用。我们使用其他情况下的监测证据和 NAFLD 患者临床过程的研究，以得出对这一不断增长的患者队列进行 HCC 监测的合理方法的建议。我们还概述了研究和实践中的差距，包括推进该领域的机会。