Research Communication: Changing Aetiology of Chronic Liver Diseases in East Asia Pacific and HCC Surveillance in Non-Cirrhotic Patients.

East Asia Pacific (EAP) faces a high burden of chronic liver disease (CLD), with metabolic dysfunction-associated steatotic liver disease (MASLD) projected to account for about 80% of CLD prevalence by 2040. Using Global Burden of Disease 2021 data, we assessed CLD trends, transitions to hepatocellular carcinoma (HCC), and the cost-effectiveness of non-cirrhotic HCC surveillance. Despite declining viral hepatitis burden, MASLD and alcohol-related CLD have risen. HCC surveillance in non-cirrhotic patients was cost-effective only for chronic hepatitis B in selected older age groups, with substantial variability across countries. These findings support refining surveillance guidelines and adaptation of risk stratification tools.