Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Comparing validated hepatocellular carcinoma risk scores for chronic hepatitis B against current Australian surveillance guidelines
Ibrahim Mian, Deloshaan Subhaharan, Adam Haig, Rupert Cox, Tariq Masood, Alicia Braund, Natalie Funakoshi, Department of Digestive Health, Gold Coast University Hospital, Gold Coast 4215, Queensland, Australia
Author contributions: Mian I, Subhaharan D, Haig A, and Funakoshi N were involved with the conception, design of the study, and were involved in the acquisition, analysis, and interpretation of data; Mian I wrote the manuscript. Mian I, Subhaharan D, Haig A, Cox R, Masood T, Braund A, and Funakoshi N critically reviewed and provided final approval of the manuscript.
AI contribution statement: ChatGPT was used in a limited capacity to assist with editing of language when drafting response to reviewer comments. No portion of the main text of manuscript was AI-generated. No AI tool was used for language polishing, translation, data analysis, or writing assistance of the manuscript. AI was not used in design of the study or interpretation of the results. No images were AI generated.
Institutional review board statement: The study was reviewed and approved by the Gold Coast Hospital and Health Service Human Research Ethics Committee, No. EX/2022/QGC/91272.
Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of the study and use of de-identified data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Ibrahim Mian, MBBS, Department of Digestive Health, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Gold Coast 4215, Queensland, Australia. ibrahim.mian@health.qld.gov.au
Received: January 4, 2026
Revised: February 18, 2026
Accepted: May 12, 2026
Published online: June 27, 2026
Processing time: 179 Days and 5.5 Hours
Revised: February 18, 2026
Accepted: May 12, 2026
Published online: June 27, 2026
Processing time: 179 Days and 5.5 Hours
Core Tip
Core Tip: Hepatocellular carcinoma (HCC) surveillance in people with chronic hepatitis B (CHB) aims to detect cancer early, however, there is a risk of over- or under-surveillance. In this Australian cohort, the validated HCC risk scores Risk Estimation for HCC in CHB, modified Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B, and Platelet Age Gender-Hepatitis B identified substantially fewer patients for surveillance compared with the current Gastroenterological Society of Australia guidelines. Importantly, these risk scores failed to identify all patients who developed HCC, highlighting the limitations of applying population-specific tools to Australia’s heterogeneous CHB population.