Preparing the Stanford Hodgkin lymphoma patient cohort for novel epidemiologic and clinical studies
For Hodgkin lymphoma (HL), a common cancer of young adults, etiology remains poorly understood, and the high survival in young patients can lead to long-term sequelae, including second cancers. Although research in HL etiology and outcomes is needed, it is challenging to conduct because achieving adequate sample sizes of patients with histories of interest is difficult. Northern California Cancer Center (NCCC) and Stanford scientists are collaborating with others on plans for HL epidemiologic studies (one of HL susceptibility based on family history of HL, one of predisposition to second primary breast cancer after radiation therapy) and wish to increase their sample sizes using eligibles among the 2,382 HL patients in the Stanford Lymphoma cohort. However, 42% of the cohort is now lost to follow-up. In a previous NCI proposal, we proposed to apply central cancer registry methods to update vital status for the cohort, find contact information for patients lost to follow-up, and contact and screen them for study eligibility; NCI reviewers requested evidence of feasibility of this approach. We now propose to pilot our methods as required to resubmit the NCI proposal. Our aims are to: 1) update patient vital status and second primary malignancies on all 2,382 Stanford patients by linkage to the California Cancer Registry database; 2) update patient contact information (address, phone number) for all 966 Stanford HL patients lost to follow-up using the NCCC's Greater Bay Area Cancer Registry internet search methods for routine patient follow-up; 3) for a sample (n≈525) of these patients, demonstrate the feasibility of contacting them to confirm new contact information and screening them for eligibility for the planned studies. Among the patients currently lost to follow-up, we anticipate identifying 96-110 with familial HL, and 33-43 with second breast cancer; including them in the planned studies will substantially improve statistical power for the stratified analyses necessitated by HL heterogeneity and analyses of gene-environment interactions for the planned studies. Thus, our study will: 1) help realize the Stanford HL patient cohort's potential as both an epidemiologic and a clinical resource; 2) use efficient population-science (cancer registry) follow-up methods; 3) provide pilot data for planned studies that meet contemporary NCI objectives, i.e., genetic susceptibility to disease occurrence and late treatment effects; and 4) provide updated clinical data of immediate usefulness.
NCCC Principal Investigator: Sally L. Glaser, Ph.D.
Co-investigators: Sandra J. Horning, M.D., Stanford University
Funding: 2006 Stanford Comprehensive Cancer Center Developmental Grant in Population Sciences Research
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