New experts are coming out against the proclamation that all Baby Boomers (those born between about 1944 and 61) should get screened for Hepatitis C. Their logic is that (besides the expense) it will cause some people to be treated “unnecessarily”.
Let’s explore “unnecessarily” for a second, because there might be some wrong preconceptions about what that means.
Breast cancer screenings, for instance, can yield a LOT of false positives that lead to unnecessary biopsies. Most of these come from self-exams, since most people are really bad at knowing what to look for. Newer recommendations advise women (and really, men) to be familiar with their breasts so they can detect changes like new, bigger lumps or hard, lego like like lumps.
Another disease known for unnecessary treatment is prostate cancer. Most men begin regular screening as part of having advanced age, but this has lead to a lot more cases, and treatment of, prostate cancer. Why is treatment unnecessary? The VAST majority of prostate cancer cases are effectively benign—they grow so slowly that they are almost never the cause of death, and don’t impact life expectancy. More and more doctors are taking a “wait and see” approach to gauge whether prostate cancer is benign or malignant before beginning treatment.
So what about Hep C?
Screening detractors are putting it somewhere near prostate cancer—it’s not that people are getting false positives, but that Hep C is so slow acting treatment is often “unnecessary”.
Here’s the thing, though. Unlike prostate cancer, Hep C usually will become a problem. One of the reasons a wide screening like this is recommended is that early treatment is much easier and much more effective than late treatment. In fact, many people don’t notice Hep C symptoms until they’re pretty serious.
Hep C is known as the silent liver killer. It takes decades for Hep C to cause damage, and all the while there’s little to no symptoms. Some people might notice fatigue, or other signs that their immune system is quietly fighting a chronic infection, but until things get bad, there’s no huge impact on quality of life.
That’s why some are saying we shouldn’t be calling for widespread testing. (Cynically, I suspect a changing healthcare landscape might play a part, too).
But here’s another extremely important point: Hep C is super contagious. It survives outside the body longer than, say HIV, and can be transmitted from a small amount of blood (making it an STD, too).
Finally, why are Baby Boomers more at risk for Hep C? Bad luck, mostly. They grew up and were immunized at a time when a lot of important practices—like not reusing needles—weren’t in place. Previous studies have determined the risk for anyone in that generation is great enough that they should be screened, just in case.
And finding out you have Hep C isn’t so scary. There’s still a fight going to get Gilead to lower the cost of its $84K Hep C cure. In the meantime, traditional treatments have dropped in price dramatically (although the nasty side effects are still there).
Knowledge is power.
And always make sure you’re supporting your immune system!
What are your thoughts on mass screening our largest generation for Hep C?
