A scoring system based on gender, age, hepatitis B virus (HBV) DNA levels, nuclear promoter mutations and cirrhosis in patients with chronic hepatitis B (GAGHCC) was shown to be effective in predicting patients’ 5- and 10-year risk of developing hepatocellular liver cancer (HCC), according to a study conducted at Queen Mary Hospital in Hong Kong. The study was published in the Journal of Hepatology (J Hepatol 2009,50:80). A mean follow-up period of 76.8 months in 820 patients with chronic hepatitis B showed a 5- and 10-year HCC prevalence of 4.4% and 6.3%, respectively, confirmed by histology or methemoglobin combined with imaging. Multifactorial analysis showed that being male [relative risk (RR) of 2.98,P=0.025], increasing age (RR=1.07,P< 0.001), high HBV DNA levels (RR=1.28,P=0.02), nuclear promoter mutations (RR=3.66,P=0.007) and the presence of cirrhosis (RR=7.31,P< 0.001) were independent risk factors for the development of HCC. The sensitivity of a scoring system (validated in a validation population) for predicting the risk of HCC at 5 and 10 years was >84% and the specificity was >76%, with an area under the curve of 0.88 and 0.98 at 5 and 10 years, respectively. the threshold for scoring was 101, and the risk of HCC increased exponentially if the patient scored above 101.