{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:33:51Z","timestamp":1790048031517,"version":"4.0.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":141,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Taiwan Ministry of Science and Technology","doi-asserted-by":"crossref","award":["MOST 103-2325-B-002-043"],"award-info":[{"award-number":["MOST 103-2325-B-002-043"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>The age and risk level that warrants hepatocellular carcinoma (HCC) screening remains to be defined. To develop risk scores for stratifying average\u2010risk population for mass HCC screening, we conducted a pooled analysis using data from three cohorts involving 12,377 Taiwanese adults 20\u201080 years of age. During 191,240.3 person\u2010years of follow\u2010up, 387 HCCs occurred. We derived risk scores from Cox's model in two thirds of participants and used another one third for model validation. Besides assessing discrimination and calibration, we performed decision curve analysis to translate findings into public health policy. A risk score according to age, sex, alanine aminotransferase, previous chronic liver disease, family history of HCC, and cumulative smoking had good discriminatory accuracy in both model derivation and validation sets (<jats:italic toggle=\"yes\">c<\/jats:italic>\u2010statistics for 3\u2010, 5\u2010, and 10\u2010year risk prediction: 0.76\u20100.83). It also performed well across cohorts and diverse subgroups. Decision curve analyses revealed that use of the score in selecting persons for screening improved benefit at threshold probabilities of &gt;2% 10\u2010year risk, compared with current guidelines and a strategy of screening all hepatitis B carriers. Using 10\u2010year risk 2% as a threshold for initiating screening, the screening age ranged from 20 to \u226560 years, depending on the tertile of risk scores and status of hepatitis B\/C virus infection. Combining risk\u2010score tertile levels and hepatitis virus status to stratify participants was more sensitive than current guidelines for HCC detection within 10 years (89.4% vs. 76.8%), especially for young\u2010onset HCCs &lt;50 years (79.4% vs. 40.6%), under slightly lower specificity (67.8% vs. 71.8%). <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: A simple HCC prediction algorithm was developed using accessible variables combined with hepatitis virus status, which allows selection of asymptomatic persons for priority of HCC screening. (H<jats:sc>epatology<\/jats:sc> 2015;61:1934\u20101944)<\/jats:p>","DOI":"10.1002\/hep.27610","type":"journal-article","created":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T17:56:49Z","timestamp":1416592609000},"page":"1934-1944","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":48,"title":["Development of risk scoring system for stratifying population for hepatocellular carcinoma screening"],"prefix":"10.1097","volume":"61","author":[{"given":"Yi\u2010Chun","family":"Hung","sequence":"first","affiliation":[{"name":"1nstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Lin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Ren\u2010Ai Branch,Taipei City Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Jen","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine,National Taiwan University Hospital and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung","family":"Hung","sequence":"additional","affiliation":[{"name":"1nstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010Ming","family":"Lin","sequence":"additional","affiliation":[{"name":"Liver Research Unit,Chang Gung Memorial Hospital, Chang Gung University College of Medicine,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shou\u2010Dong","family":"Lee","sequence":"additional","affiliation":[{"name":"Faculty of Medicine,National Yang\u2010Ming University School of Medicine,Taipei,Taiwan"},{"name":"Division of Gastroenterology, Department of Medicine,Cheng Hsin General Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Jer","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine,National Taiwan University Hospital and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Chun","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics,Institute of Population Health Sciences, National Health Research Institutes,Zhunan,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Whei","family":"Yu","sequence":"additional","affiliation":[{"name":"1nstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2015,4,13]]},"reference":[{"issue":"4","key":"hep27610-bib-0001-20241017","first-page":"5","article-title":"The incidence and epidemiology of hepatocellular carcinoma: a global and regional perspective","volume":"15","year":"2010","journal-title":"Oncologist"},{"key":"hep27610-bib-0002-20241017","first-page":"417","article-title":"Randomized controlled trial of screening for hepatocellular carcinoma","volume":"130","year":"2004","journal-title":"J Cancer Res Clin Oncol"},{"key":"hep27610-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/ijc.10122","article-title":"Ultrasound screening and risk factors for death from hepatocellular carcinoma in a high risk group in Taiwan","volume":"98","year":"2002","journal-title":"Int J Cancer"},{"key":"hep27610-bib-0004-20241017","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/hep.23615","article-title":"Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States","volume":"52","year":"2010","journal-title":"Hepatology"},{"key":"hep27610-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/hep.24199","article-title":"American Association for the Study of Liver Diseases. 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