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Impact of treatment site on disparities in outcome among adolescent and young adults with Hodgkin lymphoma

Leukemia volume 31, pages 1450–1453 (2017)Cite this article

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Adolescents and young adults (AYAs) diagnosed with cancer between 15 and 39 years of age have poor survival when compared with patients diagnosed during childhood (1–14 years old). They also have not seen the same improvement in survival—leaving an AYA Gap.1 In light of this phenomenon, the National Cancer Institute (NCI) has deemed AYAs a vulnerable population. Hodgkin lymphoma (HL) represents a prototypical AYA malignancy, with incidence peaking between 20 and 25 years; furthermore, the improvements in childhood HL survival have not been seen in AYAs.1, 2 While previous studies have examined the impact of race/ethnicity, socioeconomic status (SES) and insurance on survival,1, 2, 3, 4, 5, 6, 7, 8 health-care delivery remains unstudied in HL AYAs. In particular, aspects of cancer care delivery such as supportive care, multidisciplinary decision-making and therapy delivery mechanisms remain unstudied. This is further complicated by the fact that there is no validated, systematic and widely available measure that captures cancer care delivery at a granular level.9, 10

To evaluate currently unmeasurable aspects of health-care delivery, we used care at NCI-designated Comprehensive Cancer Centers (CCCs; or Children’s Oncology Group (COG) for patients <21 years) to serve as a surrogate. We also investigated barriers and facilitators to access to CCC/COG facilities for AYAs with HL.

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Acknowledgements

This work was supported by the National Institutes of Health (K12CA001727) and the St Baldrick’s Foundation (JW), and includes work performed in the Survey Research Core supported by the NCI (P30CA33572).

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Authors and Affiliations

  1. Institute for Cancer Outcomes and Survivorship, University of Alabama, Birmingham, AL, USA

    J Wolfson & S Bhatia

  2. Department of Population Sciences, City of Hope, Duarte, CA, USA

    J Wolfson, C-L Sun & L Wyatt

  3. Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA

    W Stock

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  1. J Wolfson
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  2. C-L Sun
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Correspondence to J Wolfson.

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The authors declare no conflict of interest.

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Presented in abstract form: Annual meeting of the American Society of Hematology, San Francisco, CA, USA, December 2014.

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Wolfson, J., Sun, CL., Wyatt, L. et al. Impact of treatment site on disparities in outcome among adolescent and young adults with Hodgkin lymphoma. Leukemia 31, 1450–1453 (2017). https://doi.org/10.1038/leu.2017.66

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