Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

Barocas, Joshua A.; Wang, Jianbo; White, Laura F.; Tasillo, Abriana; Salomon, Joshua A.; Freedberg, Kenneth A.; Linas, Benjamin P.

doi:10.1377/hlthaff.2017.0684

Cited by 36 publications

(25 citation statements)

References 34 publications

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“…The high uptake rate of screening in this study may seem to be exceptional compared with the gradual increase in screening after recommendations on birth cohort screening in USA . However, the real acceptance rate of Korean NHE was 76.1% in 2015 because it is free, convenient, and gives various benefits to examinees.…”

Section: Discussionmentioning

confidence: 68%

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Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Kim

Chung

Choi

et al. 2018

Liver International

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Section: Discussionmentioning

confidence: 68%

“…The high uptake rate of screening in this study may seem to be exceptional compared with the gradual increase in screening after recommendations on birth cohort screening in USA. 35…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Kim

Chung

Choi

et al. 2018

Liver International

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“…In addition, US guidelines changed in 2013 to recommend universal HCV screening for all Baby Boomers, increasing the diagnosis rate of HCV. Many of these patients had cirrhosis at diagnosis and, therefore, were screened for HCC . Although the widespread treatment of HCV‐infected individuals with DAA therapy significantly reduces the lifetime risk of HCC, those who have advanced fibrosis at the time of DAA therapy remain at risk for HCC at older ages, rather than dying of hepatic decompensation …”

Section: Discussionmentioning

confidence: 99%

“…Many of these patients had cirrhosis at diagnosis and, therefore, were screened for HCC. (27)(28)(29) Although the widespread treatment of HCV-infected individuals with DAA therapy significantly reduces the lifetime risk of HCC, those who have advanced fibrosis at the time of DAA therapy remain at risk for HCC at older ages, rather than dying of hepatic decompensation. (30) Another major explanation for the rapid rise in older LT patients with HCC is the obesity epidemic, which has led to a burgeoning population of patients with NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Differential Impact of Age Among Liver Transplant Candidates With and Without Hepatocellular Carcinoma

et al. 2019

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Hepatocellular carcinoma (HCC) is the fastest‐rising cause of cancer‐related mortality in the United States and is a leading indication for liver transplantation (LT). Changes have been noted in the age of the population with chronic liver disease, but how this change affects patients with HCC is unknown. This study aims to characterize trends and transplant‐associated outcomes among patients ≥65 years old listed for LT with HCC. Using the United Network for Organ Sharing database, we analyzed all patients ≥18 years old listed for LT during 2003‐2017 in the United States in 2 groups (<65 or ≥65 years). Time trends between HCC and non‐HCC patients were compared and stratified by disease etiology. Competing‐risks and Cox proportional hazards regressions associated HCC and age with wait‐list and post‐LT survival. There were 161,724 LT candidates included: 14% were ≥65 years old at listing and 25% had HCC. The proportion of patients ≥65 years old rose significantly faster among those with HCC, as compared with those without HCC (Δ = 0.80; P < 0.001). Age ≥65 years was significantly associated with both wait‐list mortality (adjusted subhazard ratio, 1.51; 95% confidence interval [CI], 1.40‐1.64) and post‐LT mortality (adjusted hazard ratio, 1.50; 95% CI, 1.41‐1.60) in the multivariate analysis. There were significant interactions between age and HCC on both wait‐list (P < 0.001) and post‐LT mortality (P = 0.04), suggesting that older age does not impact patients with HCC as much as patients without HCC. The proportion of older adults with HCC listed for LT has nearly tripled from 2003 to 2017, and the rapidly growing population of older adults with HCC may provide an opportunity to expand LT access without compromising outcomes.

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“…A recent study showed a 2.5‐fold increase in HCV screening among commercially insured baby boomer patients over 10 years . Similarly, another study demonstrated increased HCV screening from 1.09 to 2.53 per 100,000 person‐years after release of US Preventive Service Task Force (USPSTF) guidelines, with the most dramatic increase occurring in the Northeast compared to other regions of the country . Despite these increases in HCV screening among baby boomer patients, disparities exist with some subgroups based on age, racial/ethnic minority status, gender, primary care visits, and comorbidities …”

mentioning

confidence: 99%

Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis

Jain

Rich

Ahn³

et al. 2019

Hepatology

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Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety‐net health system. We performed a multifaceted intervention that included provider and patient education, an electronic medical record–enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the preintervention and postintervention groups and used a generalized linear mixed model for patients observed in both preintervention and postintervention time frames. Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened (P < 0.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high‐risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), human immunodeficiency virus–positive patients, and homeless patients. Postintervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with more than one prior primary care appointment. Conclusion: Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels.

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Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

Cited by 36 publications

References 34 publications

Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Differential Impact of Age Among Liver Transplant Candidates With and Without Hepatocellular Carcinoma

Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis

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