A genetic variant linked to fatty liver disease, when combined with metabolic conditions such as diabetes and obesity, significantly raises the risk of hepatocellular carcinoma (HCC), the most common primary liver cancer, according to a study published in May 2026 in Alimentary Pharmacology and Therapeutics [1, 2, 3].
The research found men with a "beer gut," defined as visceral fat accumulation around internal organs including the liver, face up to nine times higher risk of developing HCC [1, 2, 3]. This is one of the first large-scale prospective studies in Asia to establish a clear connection between a fatty liver genetic change and increased liver cancer risk [1, 2, 3].
Previously, liver cancer risk assessments tested fatty liver status or metabolic conditions separately. The study showed diabetes and obesity effectively "stack" on genetic susceptibility to further raise cancer risk. Adjunct Associate Professor Daniel Huang stated, "Our findings show that diabetes and obesity effectively ‘stack’ on top of genetic susceptibility to further increase liver cancer risk. This highlights the importance of considering genetic factors together with information from routine medical checks, such as diabetes, high blood pressure, high cholesterol and being overweight, rather than viewing them separately." [1]
The genetic association appeared more prominent in individuals without chronic hepatitis B, signaling a shift in liver cancer causes from viral to non-viral origins such as fatty liver disease and metabolic syndromes [1, 2, 3]. Despite this, genetic testing is not currently part of routine liver cancer screening in Singapore [1, 2, 3].
Researchers recommend integrating genetic data with existing medical evaluations to enable targeted, risk-based screening aimed at earlier detection of liver cancer [1, 2, 3]. The study’s publication marks an important step in identifying at-risk populations by combining genetic and metabolic indicators.
