Leigh Jennifer, Mallick Ranjeeta, Brule Stephanie, Rambout Lisa, Newton Jennifer, Bossé Dominick, Cooper Curtis, Gotfrit Joanna
Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada.
Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
Curr Oncol. 2024 Dec 30;32(1):20. doi: 10.3390/curroncol32010020.
Cancer patients receiving non-endocrine therapies are at risk of hepatitis B virus (HBV) reactivation (HBVr). Guidelines recommend HBV screening prior to treatment. The Ottawa Hospital Cancer Center implemented a screening pilot for all patients receiving FOLFOX-based regimens between January and April 2023. We assessed the pilot from a quality improvement perspective. Charts were retrospectively reviewed, and patient and disease characteristics were collected. The primary endpoint was to identify the proportion of patients who underwent HBV screening prior to treatment start. Univariate analyses assessed the association between baseline characteristics and failure to screen. Quality metrics were also reviewed. There were 32/42 patients (76.2%) who completed screening, and 5 (11.9%) had a positive screen. The majority of eligible patients (59.5%) completed screening prior to the first treatment as intended. Four of five patients who tested positive were referred to Infectious Diseases. Of those, one received antivirals for chronic HBV. There were no treatment delays due to pending screening and no HBV reactivation. Receipt of prior systemic therapy was significantly associated with failure to screen (55 vs. 95%, OR 17.1 (95% CI 1.92-153), = 0.011). The results of this pilot highlight the importance of building HBV screening into standardized treatment plans and engaging all team members to ensure high levels of screening. Prior systemic therapy receipt was associated with failure to screen, and thus, programs should include education on the necessity of screening as recommended by medical guidelines.
接受非内分泌疗法的癌症患者存在乙型肝炎病毒（HBV）再激活（HBVr）的风险。指南建议在治疗前进行HBV筛查。渥太华医院癌症中心于2023年1月至4月对所有接受基于FOLFOX方案治疗的患者实施了一项筛查试点。我们从质量改进的角度评估了该试点。对病历进行回顾性审查，并收集患者和疾病特征。主要终点是确定在开始治疗前接受HBV筛查的患者比例。单因素分析评估基线特征与未进行筛查之间的关联。还审查了质量指标。42名患者中有32名（76.2%）完成了筛查，5名（11.9%）筛查结果呈阳性。大多数符合条件的患者（59.5%）按计划在首次治疗前完成了筛查。检测呈阳性的5名患者中有4名被转诊至传染病科。其中，1名患者因慢性HBV接受了抗病毒治疗。没有因筛查待办事项导致治疗延迟，也没有HBV再激活情况。既往接受过全身治疗与未进行筛查显著相关（55%对95%，OR 17.1（95%CI 1.92 - 153），P = 0.011）。该试点结果凸显了将HBV筛查纳入标准化治疗计划并让所有团队成员参与以确保高筛查率的重要性。既往接受全身治疗与未进行筛查相关，因此，项目应包括按照医学指南建议进行筛查必要性的教育。
