Only about 5% of colorectal cancers are hereditary, which is due to the low carrier rate of pathogenic gene mutations. The typical pattern of these cases is intergenerational aggregation within families and early onset. But public awareness of early diagnosis and intervention of HCRC is insufficient, resulting in most patients being diagnosed only after developing cancer, thereby missing the optimal window for treatment. This article reviews the latest developments in precision screening, treatment, evaluation and prevention strategies for HCRC, including innovative uses of artificial intelligence (AI) in molecular diagnostics, imaging technology advances, and potential application prospects. Regarding precision screening, tests of genomics, transcriptomics, microbiome, etc., combined with personalised risk stratification, can, respectively, effectively detect pathogenic mutations and “cancer-promoting” intestinal environments in the preclinical stage. AI combined with endoscopic and imaging tools has improved the accuracy of polyp detection and tumor profiling. Liquid biopsy and molecular marker detection provide new non-invasive monitoring solutions. In precision treatment, beyond traditional approaches like surgery and chemotherapy, immunotherapy with checkpoint inhibitors may be considered for HCRC patients with mismatch repair deficiency (dMMR). For patients harboring somatic mutations such as KRAS or BRAF V600E, targeted therapy can be guided by these specific mutations. Regarding precision assessment, AI incorporates microsatellite instability (MSI) detection and imaging diagnostic techniques, crucial for integrating genetic, environmental, and lifestyle data in follow-up. This helps assess the risk of recurrence and adjust the long-term medication regimens, as well as provide effective nutritional support and psychological counselling. In summary, the rapid development of precision medicine is driving the clinical management of HCRC into the era of tailored care, aiming to optimise patient outcomes.

Background: Neuroendocrine neoplasms (NENs) constitute a heterogeneous group of rare tumors that most commonly originate from the gastrointestinal tract and lungs, with a consistently rising global incidence over recent decades. Hepatobiliary neuroendocrine neoplasms (HB‐NENs), defined as primary NENs arising in the liver and biliary tract, are exceedingly uncommon, accounting for less than 0.5% of all NENs. Owing to their low incidence, atypical clinical presentations, and the paucity of large‐scale datasets, no distinct World Health Organization (WHO) classification criteria have yet been established for these entities. Epidemiological characteristics and prognostic studies of HB‐NENs remain extremely limited. Current prognostic evaluation relies predominantly on the American Joint Committee on Cancer (AJCC) and European Neuroendocrine Tumor Society (ENETS) TNM staging systems, whereas population‐level investigations into incidence trends, survival determinants, and individualized predictive tools for HB‐NENs are still largely absent. Aims: To investigate epidemiological trends (1992–2020) and prognostic factors associated with overall survival in a nationally representative cohort of patients with hepatobiliary neuroendocrine neoplasms using the Surveillance, Epidemiology, and End Results registry, with subgroup stratification by sex and race. Additionally, we aim to develop a prognostic nomogram integrating significant predictors to quantify individualized survival probabilities for this population. Methods: In this cohort study, patients diagnosed with hepatobiliary neuroendocrine neoplasms between January 1, 1975, and December 31, 2020, were identified from the Surveillance, Epidemiology, and End Results Program. Related data were used for epidemiologic and survival analysis, as well as the development and validation of a nomogram to predict the overall survival probability of individual hepatobiliary neuroendocrine neoplasms patients. Results: The age‐adjusted incidence rate of hepatobiliary neuroendocrine neoplasms increased 1.76‐fold from 1992 to 2020 (annual percentage change [APC], 2.73; 95% CI, 1.86−3.65; p < 0.05). Furthermore, the incidence of hepatobiliary neuroendocrine neoplasms in the extrahepatic bile duct increased most significantly (APC, 3.73; 95% CI, 2.03−5.46; p < 0.05), and the gallbladder also increased most significantly (APC, 3.51; 95% CI, 1.97−5.08; p < 0.05), whereas patients with hepatobiliary neuroendocrine neoplasms in the liver had no significant difference. As for tumor type, the incidence increased in hepatobiliary neuroendocrine carcinomas (APC, 2.93; 95% CI, 1.34−4.53; p < 0.05) but the incidence was stable in hepatobiliary neuroendocrine tumors. On multivariate analyzes, age at diagnosis, race, tumor size, grade, tumor type, tumor stage, and surgery were significantly associated with overall survival for hepatobiliary neuroendocrine neoplasms patients. Furthermore, a nomogram based on significant associated factors (age at diagnosis, race, tumor size, stage, type, grade, chemotherapy and surgery) was constructed to predict the 6‐month, 1‐year and 2‐year survival probability, with the concordance indexes of 0.829 (95% CI, 0.800−0.857) for the training cohort and 0.801 (95% CI, 0.745−0.857) for the validation cohort. Conclusion: In this study, the incidence of hepatobiliary neuroendocrine neoplasms has exhibited a persistent upward trend over nearly two decades. Furthermore, this study proposes that a nomogram comprising eight prognostic parameters can effectively quantify the mortality risk in hepatobiliary neuroendocrine neoplasms patients.