Tuesday, November 27, 2012

Born Between 1945 - 1965? It May Be Time to Add a Blood Test to Your To-Do List

It seems it's time to add one more item to the list of effective screening tests that can help prevent cancer.

In a new draft statement, the US Preventive Services Task Force recommended that doctors consider offering the hepatitis C virus (HCV) blood test to everyone in the US born between 1945 and 1965 (draft statement).   This new statement comes on the heals of a similar report that came out this summer from the Centers for Disease Control and Prevention that even more definitively recommended one-time HCV testing in the 1945 - 1965 birth cohort (report).

About 3 - 4 million people are infected with the hepatitis C virus in the United States, most of whom don't know it.  The infection is largely silent, often showing no symptoms, but it greatly increases the risk in later life of liver cirrhosis (and subsequent transplant) as well as liver cancer.  There are, however, lifestyle changes and medical therapies that can help control HCV and therefore lower the risk of liver damage and cancer.

Before this summer, most HCV testing criteria were based on risk.  People at high risk of infection - like injection drug users, hospital workers, and those receiving blood transfusions before 1992 (when the blood supply wasn't effectively tested for HCV) - were targeted for testing.  While this certainly helped identify infections in those typically thought of as high risk, a large percentage of people with HCV were going undetected and missing out of the chance for interventions that could greatly lower the risk of serious disease.  

While the US cohort born between 1945 - 1965 makes up just under 30 percent of the population, it accounts for a whopping 75 percent of HCV infections.   Using a broader, one-time screening recommendation in this group is intended to catch infections in those who may not fall into a typical high-risk group or who might fall through the cracks of the high-risk testing procedure.   

Worldwide 25 percent of cancer are linked to infections.  In the US and other developing countries, it's closer to 15 percent.  Steps to control such infections - like HPV, H. Pylori, HBV, and HCV - can have a big impact on rates of cancer.  New treatments can help.  Much of the future hope, though, lies in vaccines that can prevent infections from ever taking hold.  Results for the human papillomavirus (HPV) vaccine and the hepatitis B virus (HBV) vaccine hold great promise, and many others are in development.

The bottom line:
In addition to the well known cancer screening tests for colon, breast, and cervical cancer, anyone born between 1945 - 1965 should talk with a doctor or other medical professional about being tested for HCV. 

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