Sociodemographic disparities in the occurrence of medical conditions among adolescent and young adult Hodgkin lymphoma survivors

Details

• Alternative Title:
  Cancer Causes Control
• Personal Author:
  Keegan, Theresa H.M. ; Li, Qian ; Steele, Amy ; Alvarez, Elysia ; Brunson, Ann ; Flowers, Christopher R. ; Glaser, Sally L. ; Wun, Ted
• Description:
  Purpose:
  
  Hodgkin lymphoma (HL) survivors experience high risks of second cancers and cardiovascular disease, but no studies have considered whether the occurrence of these and other medical conditions differ by sociodemographic factors in adolescent and young adult (AYA) survivors.
  
  Methods:
  
  Data for 5,085 patients aged 15–39 when diagnosed with HL during 1996–2012 and surviving ≥2 years were obtained from the California Cancer Registry and linked to hospitalization data. We examined the impact of race/ethnicity, neighborhood socioeconomic status (SES), and health insurance on the occurrence of medical conditions (≥2 years after diagnosis) and the impact of medical conditions on survival using multivariable Cox proportional hazards regression.
  
  Results:
  
  Twenty-six percent of AYAs experienced at least one medical condition and 15% had ≥2 medical conditions after treatment for HL. In multivariable analyses, Black HL survivors had a higher likelihood (versus non-Hispanic Whites) of endocrine (hazard ratio (HR)=1.37, 95% confidence interval (CI): 1.05–1.78) and circulatory system diseases (HR=1.58, CI:1.17–2.14); Hispanics had a higher likelihood of endocrine diseases (HR=1.24 (1.04–1.48). AYAs with public or no insurance (versus private/military) had higher likelihood of circulatory system diseases, respiratory system diseases, chronic kidney disease/renal failure, liver disease and endocrine diseases. AYAs residing in low SES neighborhoods (versus high) had higher likelihood of respiratory system and endocrine diseases. AYAs with these medical conditions or second cancers had an over two-fold increased risk of death.
  
  Conclusion:
  
  Strategies to improve health care utilization for surveillance and secondary prevention among AYA HL survivors at increased risk of medical conditions may improve outcomes.
  
  
• Subjects:
  Adolescent Article Circulatory System Endocrine System Hodgkin Lymphoma Insurance Race/ethnicity Respiratory System Second Cancer Young Adult
• Source:
  Cancer Causes Control. 29(6):551-561
• Pubmed ID:
  29654427
• Pubmed Central ID:
  PMC6422023
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHS/United States ; K24 CA208132/CA/NCI NIH HHS/United States ; U01 CA195568/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; UL1 TR000002/TR/NCATS NIH HHS/United States ; U58 DP003862/DP/NCCDPHP CDC HHS/United States
• Volume:
  29
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5017297d9f6f3839f41da3a3fc5e904905dc4a30b207f5afb62e7f77c88b8959
• Download URL:
  https://stacks.cdc.gov/view/cdc/76959/cdc_76959_DS1.pdf
• File Type:
  [PDF - 134.19 KB ]