Affiliation:
1. Baylor College of Medicine Houston Texas USA
2. Department of Pediatrics Baylor College of Medicine Houston Texas USA
Abstract
AbstractBackground/purposePediatric Hodgkin lymphoma (HL) survivors have an increased risk of late effects following treatment. Barriers at the patient, provider, and payor level adversely affect adherence to long‐term follow‐up.MethodsWe conducted a retrospective chart review of HL survivors diagnosed from 1999 to 2014 at Texas Children's Hospital. HL survivors were considered lost to follow‐up if there were no documented visits to Texas Children's Cancer Center Long‐Term Survivor (LTS) clinic for 2 or more years after their last LTS clinic visit. Univariate and multivariable logistic regression analyses were conducted to explore factors contributing to loss to follow‐up. Reasons for not attending subsequent LTS visits were assessed by phone interviews in a subset of lost to follow‐up patients.ResultsThere were 120 HL survivors who had at least one LTS clinic visit in this timeframe; 64 (53%) were classified as lost to follow‐up, and of these, 23 (36%) were interviewed. Eleven (47%) indicated that the reason for failure to follow‐up was lack of or inadequate insurance, and seven (30%) stated they were unaware of the importance of continued follow‐up. Loss to follow‐up was associated with lack of insurance, earlier diagnosis, and lack of comorbidities in univariate analyses. Only earlier year of diagnosis (odds ratio [OR] 0.84, 95% confidence interval [CI]: 0.7–0.9, p = .01) and lack of insurance (OR 22.2, 95% CI: 4–123, p < .001) were associated with loss to follow‐up in multivariable analyses.ConclusionsInsurance status and awareness of the need for long‐term follow‐up care are key factors associated with loss to follow‐up in survivors of HL. Targeted education and low‐cost options for survivorship care are potential strategies for improving adherence to long‐term follow‐up care in HL survivors.
Subject
Oncology,Hematology,Pediatrics, Perinatology and Child Health
Reference32 articles.
1. HowladerN NooneA KrapchoM et al.SEER Cancer Statistics Review (CSR) 1975–2017.National Cancer Institute USA;2020.
2. Pediatric Lymphomas and Histiocytic Disorders of Childhood
3. NCCR*Explorer: An interactive website for NCCR cancer statistics [Internet].National Cancer Institute; 2023 Sep 7. [updated: 2023 Sep 8; cited 2024 Jan 4]. Available from:https://nccrexplorer.ccdi.cancer.gov/
4. Long-Term Cause-Specific Mortality in Hodgkin Lymphoma Patients
5. Long-Term Risk of Second Malignancy in Survivors of Hodgkin’s Disease Treated During Adolescence or Young Adulthood