Nagaoki Y, Hyogo H, Ando Y, et al. - Among patients with hepatocellular carcinoma (HCC), 23.6% had an occurrence of nonhepatitis B and nonhepatitis C viral (NBNC)-HCC.

• A rapid increase in the prevalence of NBNC-HCC has occurred.

• NBNC-HCC increased from 26.5% in 2009 to 46.3% in 2018.

• Significantly old age, and significantly higher rates of excessive alcohol consumption, T2DM, hypertension, and hyperlipidemia characterize patients with NBNC-HCC.

• The BMI and platelet count were significantly higher and the FIB-4 index was significantly lower in patients with NBNC-HCC.

• An important risk factor for HCC was metabolic syndrome.

• Patients with non-cirrhotic livers also had an occurrence of HCC.

• The FIB-4 index is possibly a valuable screening tool for HCC in patients with NBNC.