Chemoprevention of hepatocellular carcinoma associated with metabolic dysfunction-associated steatotic liver disease: an updated review

With the predicted rise in metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence over the next decade, strategies to prevent hepatocellular carcinoma (HCC), which is the third most common cause of cancer-related death, are paramount. In this narrative review, we present recent clinical and translational studies from 2020-2024, providing an updated overview of the literature on chemoprevention of HCC associated with MASLD. We specifically focus on statins, aspirin, metformin, and newer diabetes medications. These agents target specific steps in the development of HCC in MASLD, including steatosis resulting in oxidative stress, inflammation, and eventually fibrosis. All offer promising avenues for HCC chemoprevention, although statins have the strongest data at present. Further ongoing prospective studies are needed.