Adolescent Hodgkin Lymphoma Patients Not Receiving Optimal Follow-up Care

Adolescent and young adult (AYAs) survivors of Hodgkin lymphoma may not be receiving the recommended post-treatment care, according to a recent study.

Cancer is the leading cause of death in AYAs, and Hodgkin lymphoma accounts for about 12% of all new cancer diagnoses in this group. Advances in the study of Hodgkin lymphoma have led to promising prognoses for AYAs diagnosed with the disease, with most surviving longer than 5 years. Still, these patients remain at a high risk of developing a number of post-treatment health problems.

The National Comprehensive Cancer Network (NCCN) has issued guidelines for best practices regarding post-treatment Hodgkin lymphoma. A study presented at the 2016 Cancer Survivorship Symposium (January 15-16; San Francisco, California) analyzed adherence to those guidelines in 354 AYA survivors diagnosed between the ages of 15 and 39 years. The average follow up time was 6 years.

Researchers found that more than half (52%) of all survivors studied did not receive all of the necessary follow-up care recommended by the NCCN within their first year of post-treatment. Most did follow up with recommended visits, lab tests, and imaging, but very few received other forms of recommended care, such as a flu vaccine. After the first year, adherence to recommended post-treatment care was typically better. The majority of patients (96%) continued to visit with an oncologist at least once per year within the first 5 years, and 70% received recommended lab tests.

Additionally, computed tomography (CT) scans were overused in almost half of patients. Two-thirds received scans in their first 12 months of post-treatment, but 42% continued receiving scans in years 2 and 3, which are not currently part of the NCCN guidelines. Lead study author Erin E. Hahn, PhD, MPH, Department of Research and Evaluation, Kaiser Permanente Southern California, indicated that the team was unable to determine the clinical indications for these tests.

Dr. Hahn and her team concluded that better and more effective programs will be needed in order to ensure that AYA survivors of Hodgkin lymphoma are receiving the appropriate post-treatment care.