Colorectal cancer screening to identify undiagnosed hepatitis C in an Austrian cohort

Hepatitis C virus (HCV) infection remains a significant public health concern despite the introduction of direct acting antiviral agents. To reach the World Health Organization (WHO) goal of eliminating viral hepatitis as a public health threat by 2030, adequate screening strategies and early diagnosis are crucial. This study aimed to determine the prevalence of HCV infection in an Austrian cohort and assess the feasibility of incorporating HCV screening into colorectal screening programmes.

The study enrolled 1,894 asymptomatic individuals during a colorectal screening programme with a mean age of 57 (± 7 years) years. Sera of the participants were screened for HCV-specific antibodies, and blood samples of individuals with detectable HCV-specific antibodies were tested by the polymerase chain reaction (PCR) to confirm a chronic HCV infection. Furthermore, we evaluated the characteristics of these individuals including their anthropometrics, biomarkers, and liver-specific information such as those obtained with a fibroscan.

We found that 14 (0.74%) of the participants had detectable levels of HCV-specific antibodies, with 6 (0.32%) individuals being newly diagnosed with a chronic HCV infection. One of the 6 patients showed signs of liver cirrhosis. The newly diagnosed individuals included 4 cases of HCV genotype 1a and 2 cases of 1b.

Our study highlights the importance of screening for HCV infection in asymptomatic individuals, not only for those at risk of HCV exposure or with elevated liver enzymes. Incorporating HCV screening into colorectal screening programmes could be an effective strategy for increasing the rate of HCV diagnosis, thereby improving public health outcomes. Further investigation is needed regarding cost-effectiveness and strategies to reach individuals who have no access to screening programmes or do not adhere to regular preventive screenings.