ObjectivesThe PAGE‐B model consists of variables at the initiation of antiviral therapy (AVT), whereas the SAGE‐B and CAGE‐B models consist of variables after 5 years of AVT. We aimed to compare the predictive accuracy of three risk prediction models for hepatocellular carcinoma (HCC) development after 5 years of AVT in patients with chronic hepatitis B (CHB).MethodsA total of 1335 patients who initiated entecavir (ETV) treatment between 2006 and 2011 and were followed up for more than 5 years were enrolled in the study.ResultsAt ETV initiation, the median age was 49 years and the median score of the PAGE‐B model was 14. After 5 years of ETV treatment, the median SAGE‐B and CAGE‐B scores were 6 and 6. During the study period, 93 (7.0%) patients developed HCC after 5‐year treatment. In multivariate analysis, PAGE‐B (hazard ratio [HR] 1.151, 95% confidence interval [CI] 1.087–1.219), SAGE‐B (HR 1.340, 95% CI 1.228–1.463), and CAGE‐B (HR 1.327, 95% CI 1.223–1.440) models independently predicted HCC development after 5 years of treatment (all P < 0.001). The high‐risk groups of the three risk prediction models showed a significantly higher risk of HCC development compared to the medium‐ and low‐risk groups (both P < 0.05). The AUROC of the SAGE‐B (0.772–0.844) and CAGE‐B (0.785–0.838) models was significantly higher than those of the PAGE‐B model (0.696–0.745) in predicting HCC development after 5 years of treatment (both P < 0.05).ConclusionThe SAGE‐B and CAGE‐B models might be better than the PAGE‐B model in predicting HCC development after 5 years of ETV treatment.