Socioeconomic inequality and short‐term outcome in Hodgkin's lymphoma

Abstract

Socioeconomic status (SES) is a determinant of outcome in various types of cancer. The aim of this study is to analyze the impact of the SES in Hodgkin's lymphoma (HL). From 2001From to 2005 consecutive patients were prospectively followed in 5 institutions. Patients answered a questionnaire with a set of items used to determine the SES, and were then divided in 2 groups according to their SES score. There were 151 patients (78%) with a higher SES and 43 patients (22%) with a lower SES. The complete remission (CR) rate was 82%. Patients with a higher SES had a higher CR rate than those with a lower SES (85 vs. 72%, crude odds ratio 5 2.27, p 5 0.046). A lower SES and the performance status >1 were independently associated with a trend towards a lower CR, even when controlled for the other covariables of interest. Ten patients (5%) died during treatment. Death during treatment was associated with a lower SES (16 vs. 2%, p 5 0.001), a performance status >1 (p < 0.0001), a lower lymphocyte count (p 5 0.012) and weakly with a lower albumin level (p 5 0.065). With a median follow-up of 1.7 years, a higher SES was associated with a better 2-year overall survival (93 vs. 79%, p 5 0.01). In underprivileged countries, patients with a lower SES require a more careful monitoring during treatment, possibly with specific support measures. Regimens more intense than doxorubicin, bleomycin, vinblastine and dacarbazine could pose a prohibitive risk of complications in this group of patients. ' 2006 Wiley-Liss, Inc.

How much does it cost to treat children with Hodgkin lymphoma in Africa?

“…Controversies exist regarding the value of CT scans [9,10] and PET scans [11] in the follow-up of Hodgkin patients. Until such time that their value is clearly established, they should be used judiciously, on the basis of an initial clinical evaluation.…”

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

“…Although we did not have health insurance information for AYAs throughout our study period, it is likely that factors beyond health insurance are influencing these race/ethnicity and neighborhood SES associations. Inadequate long-term follow-up in patients could result in a delay in diagnosing and treating complications (27), particularly for AYAs, who tend to lack knowledge about their higher risk for developing complications (28–30). Financial concerns, including lost wages, copayments, high deductibles, childcare and transportation costs (24, 31–33) can be burdensome and influence follow-up care, particularly for AYAs with financial limitations (e.g., debt from college or starting a career).…”

A prospective study on educational level and adaptation to cancer, within one year after the diagnosis, in an older population

“…Results show that health-related QoL is affected by chronic medical morbidity in elderly patients and the level of education has weak but unique contributions to physical functioning, health perception and mental health [31]. A study on patients affected by Hodgkin's lymphoma demonstrated that low SES leads to a trend towards a lower complete remission to the disease when compared with high SES [32]. These findings support the view that cancer patients with low SES are more likely to report bad health outcomes than patients with high SES.…”