ASPO Abstracts
Assessing Hepatitis C Screening Completion Rates Using Electronic Medical Records from the University of South Florida (USF) Health System
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose: CDC recommends one-time hepatitis C virus (HCV) screening for baby boomers (born 1945-1965) as they have the highest prevalence of any birth cohort. Despite these guidelines, HCV screening test completion rates remain low (11.5%—14.1% based on 2013—2016 National Health Interview Survey estimates). We evaluated the proportion of patients who complete HCV screening when it is ordered and describe socio-demographic characteristics associated with HCV screening test completion by birth cohort. Methods: HCV screening estimates for adults treated by USF Health System from August 2015—July 2017 were assessed using electronic medical records (EMRs). Frequency distributions were computed on socio-demographic characteristics associated with HCV test completion stratified by birth cohort and p-values were calculated using chi square and Fisher’s exact tests. Analyses were stratified by year screened. Results: Analyses included 65,114 adult patients. In year 1, HCV screening rates were low. Four percent of baby boomers had screening ordered compared to 12.9% in year 2. Overall, among baby boomers, 11.3% had a HCV test ordered. In year 1, the lowest rates of test completion were among those born before 1945 (50.0%). Among baby boomers, 65.9% completed the HCV test compared to 71.0% among those born between 1966—1985, and the highest completion rates of 82.5% were observed among those born after 1985. Similar percentages of test completion were observed in year 2. Only two-thirds of the target population (baby boomers) completed HCV screening when it was ordered (final HCV screen prevalence of 3.9% [year 1] and 12.7% [year 2] with high risk patents removed). High risk is defined as HIV+, history of liver cancer, history of hepatitis, and lived with someone with hepatitis) from the analyses. Sociodemographic analyses included high-risk patients. In year 1, among baby boomers, non-Hispanic blacks had lowest completion rates (58.2%) while in year 2 Asians had the lowest (68.9%). In general, high risk patients were more likely to complete screening compared to average risk patients. Conclusions: Interventions are needed to not only increase HCV screen test ordered but to also address poor follow-through with completing the test when it is ordered.
Keywords: Hepatitis C Virus, Screening, Liver cancer