Sharma SA, et al. – This investigation was planned to evaluate the disease–specific incidence of hepatocellular carcinoma (HCC) in a large cohort of patients with cirrhosis and to develop a scoring system to predict HCC risk. By etiology of cirrhosis, HCC incidence varied markedly. Using readily available clinical and laboratory parameters, the Toronto HCC Risk Index (THRI) had a good predictive ability for HCC in patients with cirrhosis. This was validated in an external cohort. Regarding HCC surveillance, this risk score could help to guide recommendations among patients with cirrhosis.