AAFP Recommends Against Screening Low-risk Population
June 13, 2014 04:45 pm Chris Crawford – On May 27, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation(www.uspreventiveservicestaskforce.org) that screening for hepatitis B virus (HBV) infection should be performed in people at high risk for infection. The recommendation was based on a systematic review of evidence conducted to update the task force’s 2004 recommendation statement.
“The AAFP Commission on Health of the Public and Science felt it was important to continue to recommend against screening the low-risk population,” said Doug Campos-Outcalt, M.D., M.P.A., of Phoenix. “The AAFP agrees with screening those at high risk, but believes we should not offer universal screening for hepatitis B.”
Campos-Outcalt, the AAFP liaison to the USPSTF, said the reasoning behind the AAFP’s recommendation against screening the low-risk population included the fact that the rates of HBV infection in those not at high risk are very low. “In addition,” he added, “an increasing percentage of the population is immune secondary to childhood vaccination. HBV has been on the recommended routine immunization schedule for about 25 years.”
An influential health advisory group has reversed itself and concluded
that all baby boomers should be tested for hepatitis C, meaning that
under the new health law many insurance plans will have to provide
screening without charge to patients.
The group, the United States Preventive Services Task Force, announced its change of heart on Monday, saying there was likely to be some benefit from such screening.
This is great news – the grade from USPSTF was changed from a grade C to grade B which means that screening for HCV in people born between 1945 and 1965 will be covered by medical insurance and in the Affordable Care Act. This is a game changer—Alan Franciscus
Description: Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for and treatment of hepatitis C virus (HCV) infection in asymptomatic adults.
Methods: The Agency for Healthcare Research and Quality commissioned 2 systematic reviews on screening for and treatment of HCV infection in asymptomatic adults, focusing on evidence gaps identified in the previous USPSTF recommendation and new studies published since 2004. The evidence on screening for HCV in pregnant women was also considered.
Population: This recommendation applies to all asymptomatic adults without known liver disease or functional abnormalities.
Recommendation: The USPSTF recommends screening for HCV infection in persons at high risk for infection. The USPSTF also recommends offering 1-time screening for HCV infection to adults born between 1945 and 1965. (B recommendation)
The U.S. Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without related signs or symptoms.
It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.
The USPSTF recognizes that clinical decisions involve more considerations than evidence alone.
Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.