Hepatitis C virus screening rates low in baby boomers, despite USPSTF recommendations

Among baby boomers, the prevalence of testing for hepatitis C virus (HCV) increased only slightly from 2013 to 2015, despite a recommendation for one-time testing in baby boomers issued by the US Preventative Services Task Force (USPSTF), according to recent study results published in the American Journal of Preventive Medicine.

Estimates hold that roughly 3.5 million Americans are infected with chronic hepatitis C virus infection, and a full 80% may be baby boomers—or those born between 1945 and 1965.

Researchers used data from the 2013 and 2015 National Health Interview Survey, which included 23,967 baby boomers. Their primary outcome was self-reported HCV blood testing. Their analyses were restricted to respondents with available HCV testing data (n=21,827), and researchers calculated the weighted prevalence of HCV testing by sociodemographic and lifestyle factors.

They found that from 2013 to 2015, HCV testing prevalence in baby boomers was slightly increased, from 12.3% to 13.8% (P=0.013). Among 76.2 million estimated baby boomers in 2015, only 10.5 million reported ever having HCV testing.

Compared with privately insured adults, boomers with Medicare plus Medicaid had a higher HCV testing prevalence (PR: 1.83; 95% CI: 1.32, 2.53), as did those with Medicaid only (PR: 1.35; 95% CI: 1.04-1.76) and military insurance (PR: 1.62; 95% CI: 1.16, 2.26).

Men also had a greater prevalence of HCV testing compared with women (PR: 1.25; 95% CI: 1.08, 1.44). Those individuals who had lived with someone with hepatitis also had a higher prevalence of testing compared with those who did not (PR: 2.44; 95% CI: 1.08, 1.44). Finally, researchers found that those with less than or only a high school education had lower HCV testing rates (PR: 0.63; 95% CI: 0.48, 0.82) compared with college graduates (PR: 0.58; 95% CI: 0.48, 0.72).

“There was a small, albeit statistically significant, increase in HCV testing (from 12.3% to 13.8%) among baby boomers 2 years after the 2013 USPSTF recommendation for one-time HCV testing. Reasons for the overall slow uptake of testing may include barriers to preventive care; unapparent symptoms; lack of awareness of the need to be tested among patients, who may not be fully covered by insurers; and lack of physician awareness of the USPSTF recommendations,” concluded authors Ahmedin Jemal, DVM, Phd, and Stacey A. Fedewa, PhD, Surveillance and Health Services Researchers, American Cancer Society, Atlanta, GA.

The American Cancer Society funded the analysis, interpretation, and presentation of the manuscript. Staff in the Surveillance and Health Services Research of the American Cancer Society designed and conducted the study, including analysis, interpretation, and presentation of the manuscript.