Adolescent and Young-adult Survivors of Hodgkin Lymphoma May Not Adhere to Follow-up Recommendations

Adolescent and Young-adult Survivors of Hodgkin Lymphoma May Not Adhere to Follow-up Recommendations
Adolescent and Young-adult Survivors of Hodgkin Lymphoma May Not Adhere to Follow-up Recommendations

SAN FRANCISCO, CA—Within the first year posttreatment, more than half (52%) of Hodgkin lymphoma survivors did not receive all recommended care. However, 96% had their recommended oncology visits and 70% had the recommended laboratory tests within the first 5 years. These findings were reported at the 2016 Cancer Survivorship Symposium .

“Patients treated for Hodgkin lymphoma are at high risk for recurrence and relapse, as well as serious long-term and late effects,” said lead study author Erin E. Hahn, PhD, MPH, a research scientist at Kaiser Permanente Southern California, Department of Research and Evaluation in Pasadena.

“We need a systematic way to deliver posttreatment care, including screening for late effects of treatment. Studies like this will help inform the design of survivorship care programs that address all our patients' needs.”

Follow-up care allows a patient's health care team to see if the cancer has returned, manage any side effects, and monitor overall health. Though standard treatments of chemotherapy and radiation for Hodgkin lymphoma are very effective and most patients survive past 5 years, survivors remain at high risk for long-term and late effects of treatment, such as heart and thyroid problems, lung disease, second cancers, infertility, and psychosocial problems. The onset of late effects varies, with complications emerging as late as 10 years after treatment, in some cases.

Posttreatment guidelines are published by the National Comprehensive Cancer Network (NCCN), and the study assessed adherence to these guidelines. The study included 354 survivors of Hodgkin lymphoma whose disease was diagnosed at 15 years to 39 years. The average length of follow-up was 6 years.

The commonly lacking services were psychosocial counseling and appropriate vaccines. Patients whose disease was diagnosed in more recent years (2006 to 2010) were more likely to adhere to the recommended posttreatment care than were those whose disease was diagnosed between 2000 and 2005.

Imaging to screen for recurrences and new cancers was both overused and underused. Two-thirds of survivors underwent a recommended CT scan in the first 12 months posttreatment; however, nearly half also received nonrecommended CT scans in year 2. In addition, a third of survivors underwent nonrecommended surveillance PET scans. However, Hahn stressed that the researchers were unable to determine clinical indications of these imaging tests.

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