title: Acceptability and yield of birth-cohort screening for hepatitis C virus in a Canadian population being screened for colorectal cancer: a cross-sectional study.
abstract: BACKGROUND
  Screening for hepatitis C virus (HCV) is recommended in patients born between 1945 and 1965 ("baby boomers") in the United States. Because these patients are often screened for colorectal cancer, dual screening for HCV may enhance case identification. Our objectives were to assess the acceptability and yield of screening for HCV among patients undergoing screening for colorectal cancer.
  
  
  METHODS
  Patients referred for a colonoscopy to screen for colorectal cancer completed an anonymous survey regarding the acceptability of screening for HCV, risk factors and prior testing. The impacts of demographics and risk factors for HCV on willingness to be screened were determined using logistic regression, and the stored sera of 483 patients who had undergone screening for colorectal cancer between February 2011 and August 2012 were tested for HCV antibodies.
  
  
  RESULTS
  Among 1012 survey respondents (median age 56 yr; 911 [90.0%] were baby boomers, 880 [87.0%] were white and 223 [22.0%] were born outside Canada), 123 patients (12.2%) reported prior testing for HCV. HCV was previously diagnosed in 9 of these patients (0.9%, representing 1.0% of the patients who were baby boomers): 5 (55.6% of those diagnosed) reported risk factors. Excluding patients diagnosed with HCV, 903 (90.0%) respondents indicated that they would consent to testing of blood or saliva for HCV. After adjusting for age, sex and status of immigration, patients who were white (odds ratio [OR] 3.38, 95% confidence interval [CI] 1.81-6.32) and patients with risk factors (> 1 v. 0: OR 3.67, 95% CI 1.12-12.02) had a greater acceptance of screening. Among 483 patients screened for colorectal cancer, 3 were anti-HCV positive (0.6%, 95% CI 0.1%-1.8%), representing 0.8% (95% CI 0.2%-2.4%) of the patients who were baby boomers.
  
  
  CONCLUSIONS
  Acceptance of screening for HCV is high among patients undergoing screening for colorectal cancer in the Calgary area. However, the low prevalence of HCV suggests that the cost-effectiveness of birth-cohort screening in this population warrants evaluation.
authors.affiliation: Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alta. ; Department of Community Health Sciences, University of Calgary, Calgary, Alta.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Myers
authors.affiliation: Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alta.
authors.forename: Pam
authors.initials: P
authors.lastname: Crotty
authors.affiliation: Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alta.
authors.forename: Susanna
authors.initials: S
authors.lastname: Town
authors.affiliation: Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alta.
authors.forename: Janine
authors.initials: J
authors.lastname: English
authors.affiliation: Provincial Laboratory for Public Health, Calgary, Alta.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fonseca
authors.affiliation: Provincial Laboratory for Public Health, Calgary, Alta.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tellier
authors.affiliation: Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alta.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Swain
authors.affiliation: Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alta.
authors.forename: S Elizabeth
authors.initials: SE
authors.lastname: McGregor
authors.affiliation: Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alta.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Heitman
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alta. ; Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, Alta.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hilsden
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