Table 1.
Screening Practices for Chronic Hepatitis B Infection in Patients Starting Chemotherapy for Solid Tumors
| Question | No. (N = 188) | % |
|---|---|---|
| 1. In your current practice, do you ever screen for hepatitis B infection in patients starting chemotherapy for solid tumors? (Please note that screening differs from investigation of abnormal physical examination, blood test, or imaging results) | ||
| Yes | 100 | 53 |
| No | 88 | 47 |
| “No” responders proceeded to question 9 | ||
| 2. How long have you been screening for hepatitis B infection? | ||
| < 1 yr | 16 | 16 |
| 1-2 yr | 29 | 29 |
| 2-5 yr | 26 | 26 |
| > 5 yr | 29 | 29 |
| 3. What is your rationale for screening patients? (can choose multiple) | ||
| Adequate evidence base for global screening | 10 | 10 |
| Adequate evidence base for screening in selected subgroups | 42 | 42 |
| Guidelines of professional society | 16 | 16 |
| Hospital-based recommendations or policy | 39 | 39 |
| Anecdotal experience of hepatitis B reactivation | 46 | 46 |
| Other | 13 | 13 |
| 4. Do you screen all patients or selected subgroups? | ||
| All patients | 35 | 35 |
| Selected subgroups | 65 | 65 |
| “All patients” responders proceeded to question 7 | ||
| 5. Do you select patients for screening on the basis of (can choose multiple) | ||
| Tumor type? | 19 | 29 |
| Chemotherapy regimen? | 21 | 32 |
| Patient ethnicity? | 53 | 82 |
| Other patient factors? | 29 | 45 |
| All responses other than “tumor type” proceeded to question 7 | ||
| 6. In which tumors do you screen for hepatitis B before chemotherapy? (can choose multiple) | ||
| Breast cancer | 8 | 42 |
| Lymphoma | 12 | 63 |
| Other | 7 | 37 |
| 7. Which pathology tests do you request when screening? (can choose multiple) | ||
| Hepatitis B surface antigen | 72 | 72 |
| Hepatitis B anti-core antibody | 43 | 43 |
| Hepatitis B surface antibody | 40 | 40 |
| Unsure, eg, as per pathology laboratory protocol | 29 | 29 |
| I also screen for hepatitis C infection | 56 | 56 |
| I also screen for HIV infection | 16 | 16 |
| 8. In detected hepatitis B–positive patients does your management involve (can choose multiple) | ||
| Monitoring only? | 11 | 11 |
| Antiviral treatment, eg, lamivudine? | 56 | 56 |
| Referral to a specialist unit, eg, infectious diseases or liver unit? | 88 | 88 |
| Other? | 3 | 3 |
| Only oncologists answering “No” to question 1: | ||
| 9. What is your rationale for not screening patients (can choose multiple)? | ||
| Inadequate evidence for a benefit of screening | 63 | 72 |
| Unsatisfactory cost-benefit ratio for screening | 20 | 23 |
| Concern about delaying or unduly complicating chemotherapy | 4 | 5 |
| Other | 29 | 33 |