Screening for malignancy and immunisation for viral hepatitis in NAFLD

Patients with nonalcoholic fatty liver disease (NAFLD) who have cirrhosis are at risk of hepatocellular carcinoma and require 6-monthly surveillance.

All patients with nonalcoholic fatty liver disease should be screened for non-liver malignancies according to current guidelines, because non–liver-related malignancy is the second leading cause of death. The Royal Australian College of General Practitioners (RACGP) provides guidelines on early detection of cancers in the Guidelines for preventive activities in general practice.

In addition to routinely recommended immunisations, consider hepatitis A and B immunisation to avoid additional preventable liver disease. See the Australian Immunisation Handbook for details.