Cho Y, et al. - Because the role of screening colonoscopy in biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients in the detection of advanced colorectal neoplasm [defined as an adenomatous polyp greater than 10 mm in diameter and/or with villous histology and/or with high-grade dysplasia or adenocarcinoma] is not clearly evidence-based, researchers, therefore, investigated whether NAFLD's histological severity is correlated with advanced colorectal neoplasm. Study participants included patients ≥18 years old who had screening colonoscopy between 2013 and 2018 within a biopsy-evaluated prospective NAFLD cohort. According to data, advanced colorectal neoplasm prevalence was 11.1%. Investigators found that advanced colorectal neoplasm patients had a higher grade of steatosis and higher stage of hepatic fibrosis vs those with normal colonoscopic findings or low-grade adenomatous polyp. Multivariable logistic regression analysis showed that the presence of nonalcoholic steatohepatitis (NASH) was an independent risk factor for both colorectal polyp and advanced colorectal neoplasm. Among patients with NAFLD, the presence of biopsy-proven NASH was significantly linked to an increased risk of advanced colorectal neoplasm. This finding may warn doctors to perform colonoscopy screening in NASH patients for early detection of advanced colorectal neoplasm.