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Risk Scores for Stratifying Hepatocellular Carcinoma and Optimizing Surveillance Strategies
1
Department of Internal Medicine, National Taiwan University Biomedical Park Hospital, Hsinchu 302058, Taiwan
2
Department of Internal Medicine, National Taiwan University Hospital, Taipei 100229, Taiwan
3
Hepatitis Research Center, National Taiwan University Hospital, Taipei 100229, Taiwan
4
Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Douliou 640203, Taiwan
*
Author to whom correspondence should be addressed.
Cancers 2026, 18(1), 158; https://doi.org/10.3390/cancers18010158
Submission received: 27 November 2025
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Revised: 25 December 2025
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Accepted: 30 December 2025
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Published: 2 January 2026
(This article belongs to the Special Issue Prevention, Early Detection, and Surgical Oncology in Hepatocellular Carcinoma, Pancreatic Cancer, and Gastrointestinal Cancer)
Simple Summary
This review highlights the limitations of current hepatocellular carcinoma (HCC) surveillance and emphasizes the need for improved identification of individuals at risk. It summarizes validated HCC risk scores that rely on readily available demographic, clinical, or molecular parameters, rather than specialized or inaccessible tests.
Abstract
Background: Hepatocellular carcinoma (HCC) is a major global health burden, with poor outcomes largely due to diagnosis at an advanced stage and the limited performance of current surveillance tools. Ultrasound with alpha fetoprotein (AFP) provides insufficient sensitivity for early-stage detection, highlighting the need to better identify the at-risk population. Focus of the review: Many HCC risk scores have been proposed; however, some depend on specialized laboratory data that are not widely available. This review summarizes risk scores that show reliable discrimination and rely on demographic, clinical, or molecular information that can be readily obtained in routine care. Conclusions: Advances in HCC risk scores support the move toward surveillance approaches based on individual risk. These tools can improve risk stratification, increase the likelihood of early detection, and potentially support better outcomes for people who belong to the at-risk population for HCC.
