Hepatitis C virus screening remains low among baby boomers

Screening for hepatitis C virus (HCV) among baby boomers has increased only slightly over time, according to a new study.

Data from 2015 indicates that less than 13 percent of individuals born between 1945 and 1965, are estimated to have undergone HCV screening.

The researchers published the results on March 27, 2018 in Cancer Epidemiology, Biomarkers & Prevention.

More than three-quarters of HCV-positive Americans were born between 1945 and 1965. That’s why both the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force now recommend that baby boomers get screened for the virus.

“Hepatitis C is an interesting virus because people who develop a chronic infection remain asymptomatic for decades and don’t know they’re infected. Most of the baby boomers who screen positive for HCV infection were infected over 30 years ago, before the virus was identified,” said lead author Monica Kasting, PhD, postdoctoral fellow, Division of Population Science, at the Moffitt Cancer Center in Tampa, Fla.

Data from the 2013 National Health Interview Survey (NHIS), an annual weighted survey of the U.S. civilian noninstitutionalized population, indicated that only 12 percent of baby boomers had been screened for HCV. Kasting and colleagues studied whether HCV screening rates had increased following the FDA approval of several well-tolerated, effective direct-acting antiviral treatments for HCV infection.

The researchers analyzed NHIS data from 2013-2015 on HCV screening prevalence among 4 different age cohorts: 15,100 participants born before 1945; 28,725 participants born 1945-1965; 28,089 participants born 1966-1985; and 13,296 participants born after 1985. Participants were asked if they had ever been tested for HCV. Certain populations who were more likely to be screened for the virus were excluded from the analysis.

A multivariable analysis showed that females were screened less often than males in every age cohort. Additionally, among baby boomers and those born between 1966 and 1985, HCV screening rates were lower among Hispanics and non-Hispanic Blacks. “This is concerning because these groups have higher rates of HCV infection and higher rates of advanced liver disease. This may reflect a potential health disparity in access to screening, and therefore treatment, for a highly curable infection,” said Kasting.

HCV screening only increased minimally in the baby boomer population. Among baby boomers, HCV screening rates ranged from 11.9 percent in 2013 to 12.8 percent in 2015. Regardless of the federal screening recommendations, less than 20 percent of baby boomers reported that the reason for their screening was due to their age. HCV screening was also significantly associated with age, gender, and race/ethnicity in baby boomers.

The researchers acknowledge that self-reported data is a limitation of the study. “Another limitation is that this is secondary data and we didn’t collect it ourselves. There are several questions we would have liked to ask about behavioral risk factors, such as drug use, that weren’t utilized on this survey,” said Kasting.

The researchers believe that interventions are needed to increase HCV screening with special focus on groups demonstrating significantly lower screening rates, such as Hispanics and females.