Background
To date, there is no definitive consensus on screening guidelines for Hepatitis B prior to commencement of curative intent chemotherapy.
This study aimed to evaluate the rates of Hepatitis B viral (HBV) testing amongst Cabrini oncologists for patients receiving adjuvant chemotherapy for breast and colon cancer.
According to EviQ recommendations, routine screening for HBV should be undertaken prior to initiation of chemotherapy for all patients with haematological malignancies or solid tumours receiving curative treatment.
Given the number of people undergoing cancer therapy and the prevalence of HBV in Australia, a significant proportion are likely to be at risk of HBV reactivation.
A 2011 study showed a rate of 19% universal pre-chemotherapy HBV screening rate amongst Australian oncologists which is similar to that of American oncologists (14%).1
Methods
A retrospective audit was conducted of patients who received adjuvant chemotherapy for breast or colorectal cancer.
The patient records were reviewed specifically looking for pre-chemotherapy HBV screening.
The outcomes of the screening tests were also recorded.
Results
A total of 315 patient records (n=315) were reviewed.
There were 243 breast cancer patients and 72 colorectal patients.
40/315 were screened for HBV prior to chemotherapy (12.6%).
9 breast cancer patients (4%) and 31 colorectal patients (43%) were screened.
Of the 40 patients screened, none were positive for prior or current HBV infection.
Conclusions
This study provides an evidence-based insight on current practice at Cabrini Health in administration of adjuvant chemotherapy for breast and colorectal cancer.
At present the rates of screening for HBV at Cabrini Health are consistent with current practice in Australia and America.
We strongly recommend that all patients who are being treated with curative intent be screened for HBV regardless of risk factors as a matter of best practice.