As public health agencies in the United States and worldwide recommend wider hepatitis C virus (HCV) screening, a collection of medical experts is asking whether the population-level benefits of such an expansion will outweigh any potential risks. Three physicians and a medical investigative journalist have published an essay in the British Medical Journal (BMJ) in which they highlight the fact that there have been no studies establishing the net benefit or drawbacks of wider screening.

In 2012 and 2013 the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) respectively recommended all Americans born between 1945 and 1965 receive hep C testing. The World Health Organization made its own plea for expanded screening in 2014. Beforehand, testing was only recommended for those at high risk, including injection drug users and people who received blood transfusions before 1992.

When making its recommendations in 2013, the USPSTF itself pointed out that there have been no studies on the long-term harms linked to hep C treatment or the outcomes of treatment in those detected through such screening.

“We know current medications can result in the virus becoming undetectable in a high number of people after 3 to 6 months. But 80 percent of people with hepatitis C do fine with or without treatment,” Kenneth W. Lin, MD, an associate professor at Georgetown University School of Medicine who was a coauthor on the BMJ essay, said in a press release. “We need to know if the treatments have any long-term impact on the remaining 20 percent who are destined to develop liver failure, liver cancer or die from the disease.

“Since most individuals with hepatitis C never develop symptoms and die with it not of it, exposing these individuals to the harms of treatment with no possible benefit might outweigh benefits for the minority destined to develop end-stage disease,” Lin said.

To read the press release, click here.

To read the Bloomberg report, click here.

To read the paper, click here.