On August 17, 2012, the Centers for Disease Control and Prevention (CDC) issued a recommendation that all persons born between 1945 and 1965 (“baby boomers”) get screened for hepatitis C at least once in their life. This call for increased testing and awareness was an exciting moment as baby boomers represent 75% of the more than 4 million cases of hepatitis C in this country, and most of these individuals do not know they are infected.
The CDC recognized that the best way to identify these individuals (so they can benefit from care and treatment before developing late stage liver disease) is to ensure that they have an opportunity to be tested once as a matter of routine practice and without stigma. Research has shown that this would result in identifying over 800,000 cases, avoiding up to 121,000 deaths, and preventing the need for up to 19,000 liver transplants.
On November 29, 2012, the United States Preventative Services Task Force (USPSTF) released their influential recommendations for HCV screening. These recommendations are critically important because most medical providers follow USPSTF recommendations, and insurance coverage for testing is impacted by them as well. The USPSTF issues grades: a grade of “A” or “B” is a recommendation to offer the test, whereas a “C” is a vague score where a test can be considered, but is often ignored by medical providers and insurers.
The USPSTF offered a “B” to screening certain people at risk of HCV: injection drug users and people who received blood transfusions before 1992. This is great, and we welcome this rating. However, the USPSTF gave a “C” to the screening of baby boomers. This is a very disappointing score.
As a result of the “C” rating, many baby boomers will likely not be screened for HCV. Further, the “C” grade will also make it difficult to get public and private insurers, including the Affordable Care Act, to cover the cost of hepatitis C testing. Ultimately, this “C” grade will likely mean that many individuals living with hepatitis C will continue to be undiagnosed, resulting in an untold number of deaths from liver failure, liver cancer and other complications that might have been prevented with a simple test.
The USPSTF is accepting public comment on this issue until December 24, 2012. Project Inform urges you to write to the USPSTF and ask them to change their grade for HCV screening of baby boomers from a “C” to a “B”. Check out the website of the National Viral Hepatitis Roundtable for more details and a direct link to the USPSTF website for your submission of public comment.