{"entity":{"id":"idea-prev-hcv-test-treat-surveillance-linkage","kind":"idea","name":"Cure hepatitis C in prisons and drug services, and enrol the cured in liver cancer surveillance","aka":[],"tldr":"Hepatitis C is now curable in weeks. Testing and treating where it is concentrated, and keeping those with scarring in surveillance afterwards, would cut liver cancer.","summary":"Hepatitis C is now curable in weeks, so this idea introduces opt-out testing and immediate direct-acting antiviral treatment in prisons and needle services, then automatically enrols cured patients with F3 or F4 fibrosis into liver cancer surveillance, blood-based where possible. Cure does not remove hepatocellular carcinoma risk in advanced fibrosis, and while elimination programmes in Egypt, Georgia and Australia show feasibility, the surveillance step is usually missing. The aim is fewer and earlier-stage liver cancers among people who inject drugs. The test is a regional programme with registry evaluation. Being tested at scale, it addresses the bottlenecks Prevention we already have is not deployed and Fragmented care and guideline gaps.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018)","url":"https://doi.org/10.3322/caac.21440"}],"tags":[],"related":[],"cancers":["hcc"],"sections":["prevention"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-prevention-adoption","b-care-fragmentation"],"keyPapers":["paper-islami-ca-cancer-j-clin"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Opt-out test-and-treat with surveillance linkage reduces HCC incidence and late-stage HCC among people who inject drugs by at least 40% within a decade.","rationale":"Elimination programmes in Egypt, Georgia and Australia show feasibility; the surveillance step is usually missing.","test":"Run a regional programme with registry evaluation.","maturity":"being-tested-at-scale","actor":"policy","cost":"medium","horizonYears":6},"route":"/ideas/idea-prev-hcv-test-treat-surveillance-linkage/","neighbours":{"cancer":[{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"paper":[{"id":"paper-islami-ca-cancer-j-clin","kind":"paper","name":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","route":"/key-papers/paper-islami-ca-cancer-j-clin/"}]}}