A population-based study of 2,071 Hodgkin lymphoma (HL) survivors over 15 years has discovered that while many survivors had multiple X-rays and CT scans years after treatment was finished, they often did not receive recommended cancer screening tests.
The study, available online ahead of print publication in the July issue of the American Cancer Society journal Cancer (www.interscience.wiley.com DOI 10.1002/cncr.25053), followed the survivors for up to 15 years after their HL diagnosis by evaluating physician visits, imaging studies, and the use of routine and HL-specific cancer screening tests.
Survivors had CT scans at a rate three times greater than in the general population, even 10 to 15 years after their original diagnosis. "It is not clear why the CT scans were ordered, but they certainly did not appear to be an efficient way to detect relapse, particularly this long after treatment was finished," says principal investigator David Hodgson, a radiation oncologist at the Princess Margaret Hospital Cancer Program, University Health Network, and investigator at the Institute of Clinical Evaluative Sciences.
Most HL patients never experience a relapse. For those who do, they usually know something is wrong before their doctor does. It is uncommon to detect relapse with CT alone in a patient who is feeling well.
"For these patients, the telephone, not the CT scanner, is the most important technology," says Dr. Hodgson. "Oncologists need to advise their patients what symptoms should prompt them to seek medical attention and physicians have to be able to evaluate them in a timely way to decide if imaging is needed."
Despite frequent contact with both specialists and primary care providers, many survivors did not receive recommended cancer screening tests. Among those who met criteria for routine screening, 62.5% were not screened for colorectal cancer, 32.3%
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