{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:00:08Z","timestamp":1785463208271,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102025\u201000523629"],"award-info":[{"award-number":["RS\u20102025\u201000523629"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021R1A2C2005820"],"award-info":[{"award-number":["2021R1A2C2005820"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102021\u2010NR056442"],"award-info":[{"award-number":["RS\u20102021\u2010NR056442"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102022\u2010NR067269"],"award-info":[{"award-number":["RS\u20102022\u2010NR067269"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000223831"],"award-info":[{"award-number":["RS\u20102023\u201000223831"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global incidence of early\u2010onset hepatocellular carcinoma (eHCC) is increasing significantly; however, specific risk prediction tools for young adults remain scarce. This study aimed to develop and validate predictive models for eHCC using both conventional statistical and machine learning techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 1,756,593 young adults aged 20\u201339\u2009years who underwent health screenings in South Korea between 2013 and 2014 with follow\u2010up until January 31, 2022. Participants were randomly divided into training and validation sets (1:1 ratio). Prediction models were constructed using cause\u2010specific Cox proportional hazards regression, Fine\u2010Gray subdistribution hazards regression, generalized boosted model (GBM), and generalized boosted survival model (GBM\u2010survival).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Key predictors of eHCC in the training cohort included viral hepatitis, history of non\u2010HCC cancer, liver cirrhosis, and gamma\u2010glutamyl transferase. In the validation cohort, GBM\u2010survival demonstrated best predictive performance for eHCC in young adults, with area under the receiver operating characteristic curves (auROCs) of 0.945 (1\u2010year) and 0.825 (5\u2010year). The most significant features in GBM\u2010survival were aspartate aminotransferase level, history of non\u2010HCC cancer, viral hepatitis, gamma\u2010glutamyl transferase, and serum creatinine. A global surrogate model for the GBM\u2010survival model enhanced interpretability (RMSE\u2009=\u20090.287; Pearson\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.887). Using the K\u2010group method, GBM\u2010survival achieved risk ratios of 2092.3 and 166.2 for 1\u2010year and 5\u2010year eHCC prediction, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We developed and validated robust risk prediction models for eHCC that integrated established risk factors with emerging metabolic indicators. This study provides actionable tools for risk stratification in young adults to address the growing burden of eHCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70732","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T10:53:01Z","timestamp":1779706381000},"page":"507-516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Prediction of Early\u2010Onset Hepatocellular Carcinoma: Derivation and Validation in a Nationwide Young Adult Cohort"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-8998","authenticated-orcid":false,"given":"Seogsong","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics Korea University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5002-0822","authenticated-orcid":false,"given":"Gi\u2010Ae","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine Kyung Hee University Hospital, Kyung Hee University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heejoon","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul South Korea"},{"name":"Divisions of Gastroenterology and Hepatology, Department of Internal Medicine Seoul Metropolitan Government Boramae Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Hyeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of 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National University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwamin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics Korea University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul South Korea"},{"name":"Divisions of Gastroenterology and Hepatology, Department of Internal Medicine Seoul Metropolitan Government Boramae Medical Center  Seoul South 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