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Veterans Affairs Research Supports CDC Recommendation To Screen Baby Boomers For Hepatitis C

WASHINGTON, Nov. 2, 2013 /PRNewswire/ -- In 2012, the Centers for Disease Control and Prevention (CDC) recommended a one-time screening for all Americans born between 1945 and 1965. It is estimated that 1 in 30 baby boomers has been infected with hepatitis C virus (HCV) and most don't know it. HCV is a serious liver disease including liver cancer, which is the fastest-rising cause of cancer-related deaths and the leading cause of liver transplants in the US.

Researchers at the Department of Veterans Affairs (VA) studied the health records of 5,500,392 veterans. Of those, 64.2 percent of baby boomers and 54.7 percent overall -- or more than 2.9 million -- had at least one VA screening for HCV. Of those screened, 9.9 percent of the baby boomers had HCV infection, compared with 1.7 percent of those born before 1945 and 1.1 percent of those born after 1965.

After extrapolating the infection data to the veterans not yet screened, researchers concluded that up to 51,000 more veterans of the baby boomer generation could be identified with HCV. The VA has been a leader in adopting new care models such as telehealth and Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN ECHO) in order to expand the VA capacity to take care of any additional veterans identified as having HCV infection through expanded screening. SCAN ECHO is a collaboration between Dr. Sanjeev Arora, the Director of Project ECHO at the University of New Mexico, and the VA. The SCAN ECHO project links VA primary care providers in local VA community outpatient clinics with specialist teams at VA academic medical centers to help manage patients who have conditions requiring complex care. The SCAN ECHO model enables primary care providers to share best practices and obtain case-based learning. Through SCAN ECHO, VA primary care clinicians gain new competencies to provide care that was not previously available in their communities.

They concluded that those born between 1945 and 1965 had the highest rate of infection, and the data support the CDC's recommendation to test all baby boomers one time for HCV. According to Lisa Backus, MD, PhD, "Our work should serve as a reminder to all baby boomers to get screened for HCV. Our work should also serve as an example to other healthcare organizations to prompt them to assess their own HCV screening rates and HCV prevalence rates and to make such rates public. Sharing this type of information would give public health officials better information about the prevalence of HCV in the US and would give the general public more information for making healthcare decisions."

In discussing her work at the VA, Dr. Backus says, "We are obviously interested in monitoring the HCV screening and HCV prevalence rates in future years. The VA is implementing several measures to improve HCV screening rates and it will be important to ensure that these measures work and that HCV screening rates increase. In addition, we are always interested in variation and we found variation in screening rates across the VA healthcare system in our analysis. Such variation in HCV screening rates among VA facilities provides an opportunity to study facilities with high screening rates to determine best practices and then apply those practices across the system."

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