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Poor or minority adolescent and young adult patients are less likely to beat Hodgkin lymphoma

Patients who are diagnosed with Hodgkin lymphoma between the ages of 15 and 39 are less likely to survive the disease if they are black, Hispanic, or live in a neighborhood with low socioeconomic status (SES).

The study has been published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Hodgkin lymphoma is one of the most common cancers diagnosed in adolescents and young adults (AYAs). Improvements in treatment have resulted in substantial improvements in survival, but the survival gains have not been shared across all racial, ethnic, and socioeconomic groups.

Keegan and colleagues studied data from 9,353 patients in the California Cancer Registry who were between 15 and 39 years old when they were diagnosed with Hodgkin lymphoma between 1988 and 2011. They examined the impact of race/ethnicity, neighborhood SES, and health insurance.

The researchers found that AYAs diagnosed with early-stage Hodgkin lymphoma were twice as likely to die if they resided in a lower SES neighborhood. They were also twice as likely to die if they had public health insurance or were uninsured, regardless of whether they were diagnosed at an early stage or a late stage.

Black AYA patients were 68 percent more likely to die of the disease than non-Hispanic white patients, whether they were diagnosed at an early stage or a late stage. Hispanic AYA patients diagnosed at a late stage were 58 percent more likely than non-Hispanic white patients to die of Hodgkin lymphoma; there was not a significant disparity for Hispanic patients diagnosed at an early stage.

“Identifying and reducing barriers to recommended treatment and surveillance in these AYAs at much higher risk of mortality is essential to ameliorating these survival disparities,” Keegan said.

Researchers were able to identify the first course of treatment, but did not have specific details of treatment that followed the initial period. Also, health insurance status at the time of diagnosis was not available for patients who were diagnosed before 2001, and the researchers did not have information on changes in patients’ insurance status that may have occurred after their initial treatment.

This study was funded by the Stanford Cancer Institute, the Cancer Prevention Institute of California, and the National Cancer Institute. Keegan declares no conflicts of interest.