Ongoing liver cancer screening for older people with cirrhosis after they are cured of hepatitis C virus (HCV) leads to improved overall survival rates, according to a Yale School of Medicine study.

 

In the United States, an estimated 2.4 million people are living with HCV, a known cause of hepatocellular carcinoma (HCC), the most common form of liver cancer. Baby boomers— individuals born between 1945 and 1965—make up almost three quarters of people with HCV.

 

HCV treatment is easier and shorter than ever, and most people can be cured with a brief course of combination antiviral therapy. The medications are generally well tolerated, and more than 90% of treated people achieve a sustained virological response, meaning continued undetectable virus 12 or 24 months after completing therapy.

 

Since they became available in 2014, these direct-acting antiviral drugs have helped lower rates of HCC and other HCV-related liver diseases.

 

Published in JAMA Network Open, the Yale study analyzed data on nearly 17,000 older adults with HCV-related cirrhosis, or scarring of the liver, who were cured of HCV.

 

The study found that continued liver cancer screening via ultrasound or other imaging completed every six months was associated with improved overall survival five years after an HCV cure.

 

A separate study published in JAMA Network Open earlier this year found that only about 40% of HCC cases were detected by routine screening, emphasizing the need for greater efforts to increase screening among people at risk, which includes people with viral hepatitis or fatty liver disease.

 

Liver cancer screening is not indicated for the general population, but American Association for the Study of Liver Diseases guidelines recommend regular surveillance using ultrasound imaging, with or without alpha-fetoprotein (AFP) blood tests, for people at higher risk. Even after being cured with antiviral therapy, people with chronic HCV should continue to undergo liver cancer screening if they have progressed to advanced fibrosis or cirrhosis.

 

“As the population most impacted by HCV ages, the role of HCC screening after HCV cure requires ongoing evaluation to balance its potential harms and benefits,” wrote the study. “Our findings suggest that individuals with cirrhosis should be maintained in HCC screening after HCV cure.”

 

To read more, click #Hepatitis C or #Hepatocellular carcinoma. There, you’ll find headlines such as “Hepatitis C Treatment Increased as State Medicaid Programs Eased Restrictions,”  “Hepatitis C Screening During Emergency Visit Improves Linkage to Care for Baby Boomers” and “Liver Cancer Risk Falls After Hepatitis C Treatment.”