Table 6.

Hepatocellular cancer surveillance in chronic hepatitis B

	APASL[11]	EASL[10]	AASLD[8,9]	INASL[10]	KASL[13]	WHO[14]
Threshold incidence of HCC to determine the intensity of screening	Determined individually based on the economic situation of each country	Not defined	Surveillance only if the incidence is greater than 0.2%	Not defined	Not defined	Surveillance only if incidence greater than 0.2%
Use of risk scores for HCC prediction	Recommended	Recommended	Recommended	Recommends specifically the CU-HCC score	Recommended	Recommended
Mode of surveillance	USG abdomen. Serum AFP	USG abdomen. Serum AFP	USG abdomen. Serum AFP	USG abdomen. No additional benefit of AFP	USG abdomen. Serum AFP	USG abdomen. Serum AFP
Baseline CECT/MRI	All cirrhotics	Not defined	Not recommended	Not recommended	Not recommended	Not recommended
CECT/MRI	Recommended for confirmation of suspicious lesions	Recommended for confirmation of suspicious lesions	Recommended for confirmation of suspicious lesions	Recommended for confirmation of suspicious lesions	Recommended for confirmation of suspicious lesions	Recommended for confirmation of suspicious lesions
CECT/MRI in cirrhosis	Recommended for advanced cirrhosis with high-risk scores	Not recommended	Not recommended	Not addressed specifically	Not recommended	Not recommended
Screening frequency (USG/AFP)	Non-cirrhotics 6-monthly. Cirrhotics 3 monthly. High risk 3-monthly	6 monthly	6 monthly	6 monthly	6 monthly	6 monthly
Screening at the onset of therapy	Recommended	Recommended in patients with moderate to high-risk scores	Recommended	Recommended	Recommended	Recommended
During therapy	Recommended	Recommended	Recommended	Recommended	Recommended	Recommended
After therapy	Not defined	Recommended after sustained response and HBsAg loss (in high-risk patients)	Recommended after sustained response (in high-risk patients)	Recommended after sustained response (in high-risk patients)	Recommended after sustained response	Not mentioned

APASL: Asian Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver; AASLD: American Association for the Study of Liver Diseases; INASL: Indian National Association for Study of the Liver; KASL: Korean Association for the Study of the Liver; WHO: World Health Organization; HCC: Hepatocellular cancer; CECT: Contrast-enhanced computed tomography; MRI: Magnetic resonance imaging; USG: Ultrasonography; CU-HCC: Chinese University Hepatocellular cancer; HBsAg: Hepatitis B surface antigen.