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Figure 1. Pathogenesis spectrum of MASLD and ALD leading to HCC. The accumulation of fat in a healthy liver can cause steatosis. Most individuals who engage in heavy alcohol consumption develop fatty liver. Steatosis can be alcohol-associated or metabolic dysfunction-associated, depending on the cause. This condition can lead to inflammation and fibrosis in nearly one-third of patients with ALD/MASLD. Steatohepatitis can be reversed by abstaining from alcohol, making lifestyle changes, and adjusting one’s diet. If fibrogenesis continues, it can lead to cirrhosis and eventually to HCC. The development of end-stage liver disease may be amplified at any stage by factors such as older age, genetic, and environmental factors, including alcohol intake. MASLD: Metabolic-associated steatotic liver disease; ALD: alcohol-associated liver disease; HCC: hepatocellular cancer.