title: Hepatitis B screening before chemotherapy: a survey of practitioners' knowledge, beliefs, and screening practices.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) reactivation is a potentially fatal complication of chemotherapy that can be largely prevented with medication, provided that asymptomatic HBV carriers are identified. We explored the knowledge, beliefs, and practices of Canadian oncologists/hematologists regarding HBV screening before chemotherapy.
  
  
  METHODS
  A novel questionnaire was mailed to all practicing hematologists/oncologists, where publicly accessible online physician registries facilitated identification of these specialists (71% of the Canadian physician population).
  
  
  RESULTS
  Of 504 potentially eligible practitioners, 311 (62%) responded, of whom 246 indicated that they administered chemotherapy and were thus included in final analyses. Respondents tended to underestimate the risk of HBV reactivation, and recognition of the major risk factor for HBV carriage (ie, birth in an endemic area) was low. Forty percent of respondents reported rarely or never testing for HBV before chemotherapy, and 36% reported screening only those patients with HBV risk factors. In multivariate analysis, having a predominantly hematologic practice, practitioner experience with HBV reactivation, ability to correctly estimate the risk of HBV reactivation, fewer years in practice, and female sex were independently associated with an increased likelihood of screening for HBV.
  
  
  CONCLUSIONS
  Canadian oncologists and hematologists tend to underestimate the risk of HBV reactivation and report relatively low HBV screening rates. Among those practitioners who do screen, the favored strategy is selective screening of patients with HBV risk factors. However, oncologists'/hematologists' knowledge regarding risk factors for HBV carriage seems to be low, potentially undermining the success of a selective screening strategy.
authors.affiliation: University of Toronto; University Health Network; and St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Ronita S M
authors.initials: RS
authors.lastname: Lee
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Singh
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Hicks
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology; D001291:Attitude of Health Personnel; D002170:Canada; D002353:Carrier State / Q000175:diagnosis*; D002983:Clinical Competence; D005260:Female; D019538:Health Care Surveys; D006509:Hepatitis B / Q000175:diagnosis* / Q000517:prevention & control; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D011364:Professional Practice / Q000706:statistics & numerical data; D012307:Risk Factors; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents