Universal HCV screening, linkage to care 'effective’ cancer prevention strategy
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Key takeaways:
- The MD Anderson Cancer Center initiated universal HCV screening for all new outpatients with a focus on patients with solid tumors.
- Incidence of HCV-associated HCC as a second primary malignancy decreased from 15 % to 5.7%.
BOSTON — Implementation of universal hepatitis C virus screening at cancer centers and corresponding care may positively affect HCV elimination targets and improve public health outcomes, according to a presentation at The Liver Meeting.
“Universal hepatitis C virus screening can be successfully implemented in cancer hospitals using an electronic health records-based multipronged approach to eliminate HCV and prevent HCV-associated hepatocellular carcinoma as a second primary malignancy,” Harrys A. Torres, MD, FACP, FIDSA, FAASLD, Ashbel Smith Distinguished Professor and founding director of the Hepatitis C Clinic at the University of Texas MD Anderson Cancer Center, told Healio.
The primary outcomes of the study were the proportion of the patients with reactive HCV antibody test results linked to HCV care and the proportion of patients with solid tumors who were tested for HCV following the implementation of universal screening. The secondary outcome of the study was incidence of HCV-associated HCC as a second primary malignancy following implementation of universal screening.
In October 2016, the MD Anderson Cancer Center initiated universal HCV screening for all new outpatients with a focus on those with solid tumors. Of 85,836 patients tested, 65.3% (n = 56,075) had solid tumors and were analyzed further.
According to results, the number of new patients screened significantly increased from 10.1% in the 6 months before implementation of screening to 34.4% in the last 6 months of the study.
The highest HCV prevalence rates were reported in patients with gastrointestinal (5.6%), head and neck (4%) and thoracic cancers (4%), and the prevalence of reactive HCV antibody test results was 2.3%. Of those with reactive HCV antibody test results, 59% were linked to HCV care and 73% of those had proven HCV infection. Furthermore, of those with proven HCV infection, 76% received treatment and 97% of those patients achieved sustained virologic response.
With the implementation of universal screening, incidence of HCC as a second primary malignancy in the historical control group of patients significantly decreased from 15% between 2011 and 2017 to 5.7% between 2017 and 2023. The researchers also found that universal screening led to the identification of 1,300 new outpatients.
“For the first time, it is described that in oncologic institutions universal HCV screening, with linkage to care, and treatment of infected patients is an effective cancer prevention strategy that can save many lives,” Torres said.
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Torres H, et al. Implementation of universal hepatitis C virus screening in a tertiary care cancer center. Presented at: The Liver Meeting; Nov. 10-14, 2023; Boston (hybrid meeting).
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