Need for Improvement in HCV Screening Rates in the United States

Although screening for hepatitis C virus (HCV) is on the rise, the increase is marginal and there is considerable room for improvement, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.¹

In 2012, as a result of data demonstrating that 75% of patients with HCV were born between 1945 and 1965 (i.e., baby boomers), both the Centers for Disease Control and Prevention and the US Preventive Services Task Force began recommending a 1-time screening for all individuals born within that time frame.^2-4 To evaluate the effect of these recommendations, researchers determined population estimates of HCV screening rates, using data from the 2013 to 2015 National Health Interview Surveys stratified into 4 birth cohorts (born before 1945, between 1945 and 1965, between 1966 and 1985, and after 1985).¹

They found that there has been a slight increase in screening in the baby boomer population (1.3% from 2014 to 2015), but the proportion screened for HCV (11.5%-12.8%) falls well below the national recommendation for screening. Individuals born between 1966 and 1985 had a similar rate of screening (13.7%-14.9%), whereas the older birth cohort was screened less (3.9%-4.5%). In the final model for baby boomers, the odds of HCV screening increased with each subsequent year. In addition, lower HCV screening prevalence was associated with older age, female sex, and race/ethnicity (non-Hispanic black participants and Hispanic participants) in baby boomers. Variables that were positively associated with screening included seeing a healthcare provider in the last 12 months, ever having been tested for HIV, having their blood pressure checked in the last 12 months, and having a colon cancer test in the last 12 months.

“Future research should develop interventions to increase HCV screening with special focus on groups demonstrating significantly lower screening rates, such as Hispanics and females,” concluded the authors.¹

References

1. Kasting ML, Giuliano AR, Reich RR, Roetzheim RG, Nelson DR, Shenkman E, Vadaparampil ST. Hepatitis C virus screening trends: serial cross-sectional analysis of the National Health Interview Survey population, 2013–2015. Cancer Epidemiol Biomarkers Prev. 2018;27(4):503-513.
2. Centers for Disease Control and Prevention. Hepatitis C: Why baby boomers should get tested 2016. Accessed April 20, 2018.
3. Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Morb Mortal Wkly Rep. 2012;61(RR04);1-18.
4. US Preventive Services Task Force. Final recommendation statement: Hepatitis C screening. Accessed April 20, 2018.