# Serum-biomarker-based population screening model for hepatocellular carcinoma

## TL;DR

A new two-step blood test model was developed to efficiently detect early signs of liver cancer.

## Contribution

A novel two-stage serum-based screening model for HCC combining LASSO and logistic regression with AFP.

## Key findings

- The model achieved AUC-ROC scores between 0.868 and 0.907 across five populations.
- It improved HCC risk estimates in healthy individuals with a 56.2% net reclassification improvement over AFP alone.

## Abstract

Hepatocellular carcinoma (HCC) early identification is crucial for improving patient outcomes. Current screening methods are often complex and costly. This study developed a simplified, cost-effective HCC screening model using serum marker data. A diverse study population from two Chinese hospitals was recruited, including cancer patients, hospital patients, and healthy individuals. A two-stage screening model was created: LASSO logistic regression for preliminary screening, followed by logistic regression incorporating alpha-fetoprotein (AFP). The model’s performance was evaluated in multiple cohorts. Across five populations, the model showed strong performance with AUC-ROC ranging from 0.868 to 0.907, accuracy between 87.43% and 96.96%, and sensitivity over 75% with specificity above 90%. Compared with solely AFP models, the second-stage model improved HCC risk estimates in healthy populations, with significantly higher AUC (0.930 vs. 0.827) and net reclassification improvement (NRI) up to 56.2%. This two-stage model offers a practical, cost-efficient tool for early HCC detection, addressing a significant public health need.

•The study developed a two-stage HCC screening model using serum biomarker•The model shows high accuracy in identifying HCC risk across multiple cohorts•The model provides a cost-efficient tool for early HCC detection

The study developed a two-stage HCC screening model using serum biomarker

The model shows high accuracy in identifying HCC risk across multiple cohorts

The model provides a cost-efficient tool for early HCC detection

Public health; Cancer