Socioeconomic Factors Influence Survival in Youth Hodgkin Lymphoma

MedicalResearch.com Interview with:

Theresa Keegan, PhD, MS Associate Professor Division of Hematology and Oncology UC Davis Comprehensive Cancer Center Sacramento, California 95817

Dr. Theresa Keegan

Theresa Keegan, PhD, MS
Associate Professor
Division of Hematology and Oncology
UC Davis Comprehensive Cancer Center
Sacramento, California 95817

Medical Research: What is the background for this study? What are the main findings?

Dr. Keegan: This study expanded upon our earlier work examining survival among the young population diagnosed with Hodgkin lymphoma, which can be cured about 90 percent of the time with it is diagnosed at its earliest stages.  We tracked 9,353 patients ages 15-39 who were diagnosed with Hodgkin lymphoma between 1988 and 2011. Using California Cancer Registry data, we examined the impact on survival of socio-demographic characteristics such as race/ ethnicity, neighborhood socioeconomic status (SES), health insurance, the types of treatment patients received and whether they were diagnosed with subsequent cancers.

We found that insurance coverage, neighborhood socioeconomic status (SES) and the types of treatment provided patients all played a role in survival.  Young adults diagnosed with early-stage Hodgkin lymphoma were twice as likely to die if they resided in a lower SES neighborhood. They were also twice as likely to die if they had public health insurance or were uninsured, whether they were diagnosed at an early stage or late stage.

While there were improvements in survival over time, disparities in survival persisted for some racial/ethnic groups. African American patients were 68 percent more likely to die of their disease than non-Hispanic white patients, regardless of stage at diagnosis. Hispanic AYA patients diagnosed at a late stage were 58 percent more likely than non-Hispanic white patients to die of Hodgkin lymphoma; there was not a significant disparity for Hispanic patients diagnosed at an early stage.

Medical Research: What should clinicians and patients take away from your report?

Dr. Keegan: This study identifies vulnerable subgroups of young Hodgkin lymphoma patients at higher risk of dying from their disease and points to disparities in treatment delivery and follow-up care as likely contributing factors.  Therefore, identifying and reducing barriers to recommended treatment and follow-up care is critical to improving survival for all patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Keegan: Future research will need to consider the continuity of health insurance over time and other barriers to care.

Citation:

Impact of Treatment and Insurance on Socioeconomic Disparities in Survival after Adolescent and Young Adult Hodgkin Lymphoma: A Population-Based Study

Theresa H.M. Keegan, Mindy C. DeRouen, Helen M. Parsons, Christina A. Clarke,Debbie Goldberg, Christopher R. Flowers, and Sally L. Glaser

Cancer Epidemiol Biomarkers Prev Published OnlineFirst January 29, 2016;
doi:10.1158/1055-9965.EPI-15-0756

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Dr. Theresa Keegan (2016). Socioeconomic Factors Influence Survival in Youth Hodgkin Lymphoma