Hepatocellular carcinoma (HCC) imposes a major health and economic burden worldwide, with disproportionate effects in low- and middle-income countries (LMICs). Surveillance in high-risk populations, typically using semiannual ultrasound and alpha-fetoprotein testing, has been shown to be cost-effective by enabling earlier detection and improving survival. Yet, its overall value is reduced by poor adherence and the limited sensitivity of ultrasound, particularly in patients with metabolic-associated steatotic liver disease. Emerging approaches—including abbreviated magnetic resonance imaging, multi-biomarker models (e.g., gender, age, AFP, AFP-L3, and DCP), and liquid biopsy assays such as methylated DNA markers—demonstrate greater diagnostic accuracy and potential economic advantages compared with conventional methods. Integration of artificial intelligence into imaging may further enhance efficiency and reduce downstream costs. Moving toward precision surveillance, guided by individualized risk stratification that incorporates etiology, fibrosis stage, and molecular profiles, can optimize allocation of resources and maximize cost-effectiveness at the population level. Interventions to improve adherence, including mailed outreach and behavioral economic incentives, have shown both clinical benefit and cost savings, underscoring the role of implementation science. Because socioeconomic disparities influence both access and outcomes, economic models must explicitly address equity to achieve sustainable impact. Future research should prioritize prospective trials that evaluate not only clinical performance but also the real-world cost-effectiveness of novel technologies and stratified surveillance strategies. For LMICs, adapting proven models into affordable, context-appropriate programs is essential. By combining prevention, precision risk assessment, innovative technologies, and equitable implementation, HCC surveillance can deliver both clinical and economic value, reducing the global burden of disease.

Objective It is thought that environmental agents, especially the diet, play an important role in the processes of gastric cancer. The study was designed to investigate the relationship between dietary factors and the risk of gastric cancer in residents of islands so as to offer the evidence for effective measures of prevention and control. Methods A frequency matched design of case control study was used. 103 cases of gastric cancer newly diagnosed in 2001 and 133 controls were randomly selected among the residents of islands. And dietary factors were further investigated. Adjusted odds ratios (OR) and 95% confidence intervals (CI) of dietary factors on the processes of gastric cancer were estimated using unconditional logistic regression models. Results After the correction of the effects of some non diet factors, increased risks of gastric cancer were associated with hot diet (OR=1.48,95%CI:1.03 2.14) and pickled food (OR=2.63,95%CI:1.74 3.98). An inversed association with the risk of gastric cancer was seen in sauting (OR=0.33,95%CI:0.13 0.83 ), food eaten at regular time (OR=0.29,95%CI:0.19 0.44), allium vegetables (OR=0.43,95%CI:0.22 0.82) and carrot (OR=0.10,95%CI:0.02 0.41). Furthermore, PARc% of hot diet and pickled food were 11.8% and 57.8% respectively, which suggested that the carcinogenic effect of hot diet and pickled food on stomach in the population reached about 70% after the correction of the effect of other factors.Conclusions Pickled food and hot diet as the habits of residents in Zhoushan islands are important risk factors for gastric cancer, while decreased risk effect is found in sauting food, having regular dietary time and frequently eating allium vegetables and carrot.