non-alcoholic fatty liver disease as a risk for colorectal cancer development and the role of screening colonoscopy in clinical practice

colorectal cancer (crc) is still the third mostcommoncancer in the world, which is the fourth cause of cancer-related mortality. it is caused either due to strong genetic factors such as familial adenomatous polyposis (fap) and hereditary non-polyposis colon cancer orduetomodifiedmetabolic factors such as obesityanddiabetes, whichrepresents insulin resistance condition. non-alcoholic fatty liver disease (nafld) is increasing not only inwestern countries but also in asian countries. this disease has been included in the metabolic disease family such as diabetes, hypertension, obesity, and dyslipidemia. some studies have shown that there is a strong association between nafld and the risk of crc development through the presence of an adenomatous polyp. however, there is currently no consensus on whether routine screening colonoscopy should be done in all nafld patients with respects to its cost and invasiveness.