Socioeconomic disparities in survival after Hodgkin lymphoma
Hodgkin lymphoma (HL) is one of the most common cancers of young adults and, because of successful treatment strategies, is generally considered curable for this age group at all stages of disease. Treatment, however, is associated with significant after-effects such that survivors experience some of the highest rates of second primary cancers, HL recurrences, and radiation-induced cardiac disease. This outcome is particularly tragic considering the young age of most HL patients and the potential years of life lost following HL. Our preliminary data and limited other prior research have revealed disparities in HL survival by socioeconomic status (SES), particularly in young adults. Therefore, utilizing California Cancer Registry (CCR) patient data enhanced by geographic linkage with US Census SES data and with hospital and physician characteristics, this study will examine the effects of neighborhood SES on long-term survival following HL. These analyses include demographic, clinical and tumor data for nearly 3,800 HL cases newly diagnosed throughout California during 1988-1992; a neighborhood SES composite index derived from the 1990 US Census based on the patient's residence at diagnosis; hospital characteristics from the American Hospital Association; and 10-15 years of vital-status follow-up information. If this study finds survival disparities, it will provide the foundation and impetus for more targeted studies to investigate the likely complex explanatory mechanisms, such as variation in access to and quality of care, incidence of side effects and management of long-term health, and health behaviors. By evaluating SES disparities in long-term survival, this study is an important first step in overcoming such disparities by helping inform decision-makers about specific populations in whom the length and quality of life can be improved following HL diagnoses.
NCCC Principal Investigator: Theresa Keegan, Ph.D.
Co-investigators: Sally L. Glaser, Ph.D., Christina A. Clarke, Ph.D.
Funding Source: National Cancer Institute, 2005-2007
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