{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:45:38Z","timestamp":1793054738217,"version":"4.5.0"},"reference-count":42,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T00:00:00Z","timestamp":1726876800000},"content-version":"am","delay-in-days":356,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01 CA237659-01"],"award-info":[{"award-number":["R01 CA237659-01"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01 CA086402"],"award-info":[{"award-number":["U01 CA086402"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","gastrojournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Gastroenterology"],"published-print":{"date-parts":[[2023,10]]},"DOI":"10.1053\/j.gastro.2023.06.027","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T19:11:02Z","timestamp":1688843462000},"page":"1053-1063.e6","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":73,"title":["Incidence and Risk Factors for Hepatocellular Carcinoma in Cirrhosis: The Multicenter Hepatocellular Carcinoma Early Detection Strategy (HEDS) Study"],"prefix":"10.1053","volume":"165","author":[{"given":"K. Rajender","family":"Reddy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"McLerran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neehar","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis R.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Befeler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Page-Lester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runlong","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo Ann","family":"Rinaudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziding","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Marrero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1053\/j.gastro.2023.06.027_bib1","doi-asserted-by":"crossref","DOI":"10.1177\/1073274817729245","article-title":"Epidemiology of hepatocellular carcinoma and intrahepatic cholangiocarcinoma","volume":"24","author":"Massarweh","year":"2017","journal-title":"Cancer Control"},{"key":"10.1053\/j.gastro.2023.06.027_bib2","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1002\/cncr.29936","article-title":"Annual report to the nation on the status of cancer, 1975-2012, featuring the increasing incidence of liver cancer","volume":"122","author":"Ryerson","year":"2016","journal-title":"Cancer"},{"key":"10.1053\/j.gastro.2023.06.027_bib3","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1016\/j.cgh.2015.08.014","article-title":"Hepatocellular carcinoma from epidemiology to prevention: translating knowledge into practice","volume":"13","author":"Singal","year":"2015","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib4","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1053\/j.gastro.2004.07.020","article-title":"Hepatitis C infection and the increasing incidence of hepatocellular carcinoma: a population-based study","volume":"127","author":"Davila","year":"2004","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2023.06.027_bib5","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1002\/hep4.1652","article-title":"A\u00a0real-world observational cohort of patients with hepatocellular carcinoma: design and rationale for TARGET-HCC","volume":"5","author":"Cabrera","year":"2021","journal-title":"Hepatol Commun"},{"key":"10.1053\/j.gastro.2023.06.027_bib6","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41575-020-00381-6","article-title":"Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention","volume":"18","author":"Huang","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib7","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1002\/cncr.22193","article-title":"Annual report to the nation on the status of cancer, 1975-2003, featuring cancer among U.S. Hispanic\/Latino populations","volume":"107","author":"Howe","year":"2006","journal-title":"Cancer"},{"key":"10.1053\/j.gastro.2023.06.027_bib8","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1056\/NEJMra1713263","article-title":"Hepatocellular carcinoma","volume":"380","author":"Villanueva","year":"2019","journal-title":"N\u00a0Engl J Med"},{"key":"10.1053\/j.gastro.2023.06.027_bib9","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1016\/j.cgh.2016.07.001","article-title":"Safety and effectiveness of direct-acting antiviral agents for treatment of patients with chronic hepatitis C virus infection and cirrhosis","volume":"14","author":"Maan","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib10","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/hep.29408","article-title":"Impact of sustained virologic response with direct-acting antiviral treatment on mortality in patients with advanced liver disease","volume":"69","author":"Backus","year":"2019","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib11","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1053\/j.gastro.2017.06.012","article-title":"Risk of hepatocellular cancer in HCV patients treated with direct-acting antiviral agents","volume":"153","author":"Kanwal","year":"2017","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2023.06.027_bib12","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/14740338.2018.1404026","article-title":"Things fall apart with hepatocellular carcinoma and direct-acting antivirals","volume":"17","author":"Kutala","year":"2018","journal-title":"Expert Opin Drug Saf"},{"key":"10.1053\/j.gastro.2023.06.027_bib13","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.jhep.2016.04.008","article-title":"Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy","volume":"65","author":"Reig","year":"2016","journal-title":"J\u00a0Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib14","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/apt.13440","article-title":"Entecavir safety and effectiveness in a national cohort of treatment-naive chronic hepatitis B patients in the US - the ENUMERATE study","volume":"43","author":"Ahn","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1053\/j.gastro.2023.06.027_bib15","doi-asserted-by":"crossref","first-page":"e4433","DOI":"10.1097\/MD.0000000000004433","article-title":"Lower liver cancer risk with antiviral therapy in chronic hepatitis B patients with normal to minimally elevated ALT and no cirrhosis","volume":"95","author":"Hoang","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"10.1053\/j.gastro.2023.06.027_bib16","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1111\/apt.13774","article-title":"Reduction of chronic hepatitis B-related hepatocellular carcinoma with anti-viral therapy, including low risk patients","volume":"44","author":"Lin","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1053\/j.gastro.2023.06.027_bib17","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/hep.28280","article-title":"Antiviral therapy for chronic hepatitis B viral infection in adults: a systematic review and meta-analysis","volume":"63","author":"Lok","year":"2016","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib18","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1053\/j.gastro.2018.08.024","article-title":"Risk of hepatocellular cancer in patients with non-alcoholic fatty liver disease","volume":"155","author":"Kanwal","year":"2018","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2023.06.027_bib19","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1002\/hep.32185","article-title":"GALAD demonstrates high sensitivity for HCC surveillance in a cohort of patients with cirrhosis","volume":"75","author":"Singal","year":"2022","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib20","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.cgh.2022.01.047","article-title":"The performance of AFP, AFP-3, DCP as biomarkers for detection of hepatocellular carcinoma (HCC): a phase 3 biomarker study in the United States","volume":"21","author":"Tayob","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib21","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1002\/hep.32434","article-title":"Risk factors for HCC in contemporary cohorts of patients with cirrhosis","volume":"77","author":"Kanwal","year":"2023","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib22","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.cct.2018.11.008","article-title":"Rationale and design of the Hepatocellular carcinoma early detection strategy study: a multi-center longitudinal initiative of the National Cancer Institute's Early Detection Research Network","volume":"76","author":"Borges","year":"2019","journal-title":"Contemp Clin Trials"},{"key":"10.1053\/j.gastro.2023.06.027_bib23","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1002\/hep.29913","article-title":"Diagnosis, staging, and management of hepatocellular carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases","volume":"68","author":"Marrero","year":"2018","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib24","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/oxfordjournals.aje.a115507","article-title":"A\u00a0simple method to calculate the confidence interval of a standardized mortality ratio (SMR)","volume":"131","author":"Ulm","year":"1990","journal-title":"Am J Epidemiol"},{"key":"10.1053\/j.gastro.2023.06.027_bib25","series-title":"Discrete distributions","author":"Johnson","year":"1969"},{"key":"10.1053\/j.gastro.2023.06.027_bib26","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jhep.2007.11.011","article-title":"Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors","volume":"48","author":"Fattovich","year":"2008","journal-title":"J\u00a0Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib27","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1002\/hep.27222","article-title":"Epidemiology of hepatocellular carcinoma in the United States: where are we? Where do we go?","volume":"60","author":"El-Serag","year":"2014","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib28","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.4254\/wjh.v7.i18.2155","article-title":"Advances in hepatocellular carcinoma: nonalcoholic steatohepatitis-related hepatocellular carcinoma","volume":"7","author":"Khan","year":"2015","journal-title":"World J Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib29","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.cld.2004.04.004","article-title":"The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease","volume":"8","author":"McCullough","year":"2004","journal-title":"Clin Liver Dis"},{"key":"10.1053\/j.gastro.2023.06.027_bib30","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1002\/hep.23527","article-title":"The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis","volume":"51","author":"Ascha","year":"2010","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib31","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.cgh.2015.07.019","article-title":"Hepatocellular carcinoma in the absence of cirrhosis in United States veterans is associated with nonalcoholic fatty liver disease","volume":"14","author":"Mittal","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2023.06.027_bib32","doi-asserted-by":"crossref","first-page":"59","DOI":"10.21037\/hbsn.2019.08.08","article-title":"Hepatocellular carcinoma in non-alcoholic fatty liver disease-a review of an emerging challenge facing clinicians","volume":"10","author":"Geh","year":"2021","journal-title":"Hepatobiliary Surg Nutr"},{"key":"10.1053\/j.gastro.2023.06.027_bib33","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/MCG.0b013e3182a030c4","article-title":"The association between metabolic syndrome and hepatocellular carcinoma: systemic review and meta-analysis","volume":"48","author":"Jinjuvadia","year":"2014","journal-title":"J\u00a0Clin Gastroenterol"},{"key":"10.1053\/j.gastro.2023.06.027_bib34","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/j.1365-2036.2010.04271.x","article-title":"Systematic review: the association between obesity and hepatocellular carcinoma - epidemiological evidence","volume":"31","author":"Saunders","year":"2010","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1053\/j.gastro.2023.06.027_bib35","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib36","doi-asserted-by":"crossref","first-page":"2584","DOI":"10.1001\/jama.2012.144878","article-title":"Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis","volume":"308","author":"van der Meer","year":"2012","journal-title":"JAMA"},{"key":"10.1053\/j.gastro.2023.06.027_bib37","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2019.07.033","article-title":"Increased risk for hepatocellular carcinoma persists up to 10 years after HCV eradication in patients with baseline cirrhosis or high FIB-4 scores","volume":"157","author":"Ioannou","year":"2019","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2023.06.027_bib38","doi-asserted-by":"crossref","first-page":"68131","DOI":"10.18632\/oncotarget.19245","article-title":"Age-specific sex difference in the incidence of hepatocellular carcinoma in the United States","volume":"8","author":"Liu","year":"2017","journal-title":"Oncotarget"},{"key":"10.1053\/j.gastro.2023.06.027_bib39","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/MD.0b013e3182779d49","article-title":"Nonalcoholic fatty liver disease in lean individuals in the United States","volume":"91","author":"Younossi","year":"2012","journal-title":"Medicine (Baltimore)"},{"key":"10.1053\/j.gastro.2023.06.027_bib40","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1002\/hep.32434","article-title":"Risk factors for hepatocellular cancer in contemporary cohorts of patients with cirrhosis","volume":"77","author":"Kanwal","year":"2023","journal-title":"Hepatology"},{"key":"10.1053\/j.gastro.2023.06.027_bib41","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1053\/j.gastro.2009.04.005","article-title":"Alpha-fetoprotein, des-gamma carboxyprothrombin, and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma","volume":"137","author":"Marrero","year":"2009","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2023.06.027_bib42","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1038\/ajg.2013.332","article-title":"Machine learning algorithms outperform conventional regression models in predicting development of hepatocellular carcinoma","volume":"108","author":"Singal","year":"2013","journal-title":"Am J Gastroenterol"}],"container-title":["Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0016508523047650?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0016508523047650?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T15:40:34Z","timestamp":1758037234000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0016508523047650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["S0016508523047650"],"URL":"https:\/\/doi.org\/10.1053\/j.gastro.2023.06.027","relation":{},"ISSN":["0016-5085"],"issn-type":[{"value":"0016-5085","type":"print"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Incidence and Risk Factors for Hepatocellular Carcinoma in Cirrhosis: The Multicenter Hepatocellular Carcinoma Early Detection Strategy (HEDS) Study","name":"articletitle","label":"Article Title"},{"value":"Gastroenterology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1053\/j.gastro.2023.06.027","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 by the AGA Institute. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}