Clinical practice of hepatitis B screening in patients starting with chemotherapy: A survey among Dutch oncologists

Eur J Cancer Care (Engl). 2021 Nov;30(6):e13495. doi: 10.1111/ecc.13495. Epub 2021 Jul 26.

Abstract

Objective: Screening for hepatitis B virus (HBV) before chemotherapy is recommended by international guidelines; still, the HBV screening rate is low, and patients remain at risk for HBV reactivation (HBVr). Because HBVr is a serious and preventable condition, we conducted a survey to evaluate the screening behaviour of oncologists in the Netherlands.

Methods: We conducted an anonymous digital survey by email to all practicing medical oncologists. The surveys were sent in two session, the first one in 2017 and the second one in 2019. Questions included HBV screening procedures, reasons for screening and experience with HBVr.

Results: Among the 110 respondents, 29 (27%) followed a standardised protocol. Overall, 13 (12%) oncologists screened all patients, 76 (70%) only screened patients they considered as high risk and 19 (18%) did not screen anyone. Fourteen percent of the respondents experienced a HBVr in one of their patients.

Conclusion: This survey suggests that universal HBV screening is not common practice and usually patients considered as at risk for HBVr are screened, while this group is not always properly identified. Introduction of a national protocol for HBV screening and adjustment of the Dutch oncology guidelines might contribute to a reduction of HBVr during chemotherapy.

Keywords: chemotherapy; guidelines; hepatitis B virus; hepatitis B virus reactivation; screening; survey.

MeSH terms

  • Hepatitis B virus
  • Hepatitis B* / diagnosis
  • Humans
  • Mass Screening
  • Oncologists*
  • Surveys and Questionnaires
  • Virus Activation