当前指南建议对高风险人群进行肝细胞癌（HCC）监测，包括乙型肝炎病毒感染者。然而，在中国人群中，年度筛查的表现和生存益处尚未通过多中心前瞻性研究进行评估。在2017年至2021年期间，我们纳入了14,426名乙型肝炎表面抗原阳性的参与者，在中国进行了一项多中心前瞻性设计的HCC年度筛查研究，使用超声和血清甲胎蛋白。经过四轮筛查和随访后，校正潜伏时间和长度时间偏倚后，既往和入组时筛查发现的癌症的死亡风险比为0.74（95%置信区间= 0.60-0.91）和0.52（95%置信区间= 0.40-0.68）。荟萃分析表明，HCC筛查与调整后的潜伏时间偏差相关联，可以改善生存率。我们的研究结果突出了在社区环境中进行年度HCC筛查的“真实世界”可行性和有效性，以实现早期HCC的检测并改善生存。© 2023. 作者，Springer Nature America, Inc.独家许可。

Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60-0.91) and 0.52 (95% confidence interval = 0.40-0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the 'real-world' feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival.© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.