Baby boomers get another screening test
I was annoyed when the US Preventive Services Task Force (USPSTF) announced last week that baby boomers, those born between 1945 and 1965 (myself included), should be tested for the liver infection hepatitis C (HCV) regardless of risk factors.
I think my age group is already subjected to too many screening tests of questionable value.
Related reading: Check and check again
Just last November the USPSTF issued a statement that only people at an increased risk of HCV—mostly IV drug users and anyone who received a blood transfusion before 1992—should be tested. Anyone could be offered the test, but the USPSTF concluded that there would be a limited “net benefit” to screening everyone.
Now they have changed their mind. They have assigned HCV screening a B grade (rather than the previous C grade), which means that they believe screening all baby boomers, not just those at high risk, might result in a “moderate net benefit.”
More importantly I think, the B-grade recommendation means that under Obamacare’s preventive services rules, the screening test (a blood test) must be covered at no charge to the patient.
Why the about face?
Even though the majority—by far—of those found positive with HCV are in a high risk group, the task force decided it was possible that:
- Baby boomers might not remember risky behaviors from their youth. Really? The oldest baby boomers are only 68.
- Patients might lie about risky behaviors. Well, maybe.
- Primary care physicians don’t know enough about testing for HCV and available treatments. I’d be offended if I were a physician.
In fact, I read a nice blog post by a family practice doc, Kenny Lin, MD, who took exception to the task force’s rationale that screening based on risk assessment was a “greater burden” to the primary care doctor than just screening everybody.
Dr. Lin wrote:
How have we really reached the point in this country where getting to know patients well enough to individualize their preventive health care is now considered a burden, rather than good medical practice?…Sure, family doctors are sometimes harried or overwhelmed or forget to ask questions, but it’s hardly a given that those same doctors will suddenly start ordering … HCV tests for every Baby Boomer who walks in the door. More likely, prompted by preventive medicine process “quality” measures built in to electronic health records, many will simply add these on to the one-size-fits-all panels of mostly unnecessary tests that they already do at routine physicals, increasing health care costs for little discernible benefit.
And then I read a business article in the New York Times that reported:
The decision is good for drug companies selling or developing drugs to treat hepatitis C, like Merck, Vertex, Gilead and AbbVie, because it means more people who harbor the virus but do not know it will be discovered, making them candidates for treatment. The decision could also help companies that make hepatitis C tests, like OraSure Technologies.
Ah, now I understand.