Susan Vadaparampil, PhD, MPH, a researcher in the Department of Health Outcomes and Behavior at the Moffitt Cancer Center in Florida, shared some of her thoughts about hepatitis C virus (HCV) and baby boomers with Provider.

Provider: Why should HCV be on our radar screens as baby boomers age?
SV: Unlike many other cancers where the death rates are decreasing and the rates of new cases remain stable, liver cancer incidence and mortality are rising—particularly among baby boomers. Half of all cases of liver cancer are caused by hepatitis C, and liver cancer is one of only three cancer types that are actually increasing in incidence in the U.S. Therefore, it is important to identify and treat people who have the virus in order to prevent cancer.

Provider: Why do baby boomers have higher incidence rates of HCV?
SV: Hepatitis C is an interesting virus because people who develop a chronic infection remain asymptomatic for decades and don’t know they’re infected. Most of the baby boomers who screen positive for HCV infection were infected over 30 years ago, before we identified the virus. This could include people who received a blood transfusion before 1992 when there was no screening in the blood supply for HCV or in health care workers who worked closely with patient bodily fluids before universal precautions were common practice.

Sharing needles or equipment used to prepare or inject drugs, even if only done once in the past, could also spread hepatitis C. According to the Centers for Disease Control and Prevention (CDC), while anyone can get hepatitis C, three in four people with hepatitis C were born between 1945 and 1965.

Provider: How can baby boomers get screened for HCV? What does it mean if someone tests positive?
SV: The easiest way to get screened for HCV is to ask your primary care provider. It is a simple blood test that is routinely performed by many laboratories. Your provider may draw your blood in the office or send you to the lab to have your blood drawn. On average, about 1 percent to 3 percent of baby boomers will have a positive result on their HCV screening. If that is the case, then your health care provider would recommend a follow-up test. If that is also positive, then you would likely be referred to a specialist who can help determine the best way to manage your treatment.

Provider: Despite recommendations from CDC that all baby boomers get screened for HCV, screening
rates are very low. What can we do to improve these rates?
SV: We believe that these low rates are, in part, due to the lack of awareness among some providers about current universal screening recommendations for baby boomers. There does not appear to be a change in screening practices that are based on behavioral risk factors, which, according to recent research, will miss approximately half of those infected with HCV. Given the importance of health provider recommendations in a patient’s preventive behaviors, we feel that involving providers in the communication and education process is critical.

While public health awareness campaigns are an important strategy to raise public awareness, an equally important strategy is to support and train providers to make strong and consistent recommendations for HCV screening.