Attendance at survivorship clinics in relation to Hodgkin lymphoma survivor and treatment characteristics.

in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer by Eline M J Lammers, Berthe M P Aleman, Michael Schaapveld, Josée M Zijlstra, Cécile P M Janus, Roel J de Weijer, Maaike G A Schippers, Rinske S Boersma, Saskia S Gommers, Mirjam Kappert, Adriaantje C Kroeze, Flora E van Leeuwen, Annelies Nijdam

TLDR

  • The study identified male sex and lack of a history of subsequent malignancy as risk factors for non-attendance at Dutch Cancer Survivorship Care clinics for HL survivors.

Abstract

Participation rates in cancer survivorship care (CSC) programs are suboptimal and reasons for non-attendance are poorly understood. To identify possible improvements of the Dutch CSC for Hodgkin lymphoma (HL) survivors, we aimed to (1) identify survivor and treatment characteristics associated with non-attendance at Dutch CSC clinics for HL survivors and (2) evaluate reasons for non-attendance. In a retrospective multicenter cohort study, we assessed attendance among 516 adult HL survivors invited to eight CSC clinics from 2013 to 2024. The associations between sex, socio-economic status, age at CSC invitation, HL treatment category, history of cardiovascular disease, history of subsequent malignancy, time since HL diagnosis, and non-attendance were assessed in multivariable logistic regression analysis. Reasons for non-attendance were retrieved from a survey sent to all non-attenders. CSC attendance was 70% (n = 363). In multivariable analysis, male sex was associated with higher odds of non-attendance compared to female sex (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.01-2.56) while a history of subsequent malignancy was associated with lower odds of non-attendance (OR 0.41, 95% CI 0.19-0.89). Of all non-attenders, 44 (28.8%, of whom 45.5% male) responded to the survey. Frequently reported reasons for non-attendance were surveillance or treatment for late effects elsewhere (n = 17) and emotional burden of clinic visit (n = 15). Our findings inform attempts to improve attendance at Dutch CSC clinics for HL survivors. Active involvement of healthy (male) survivors in improvement of the survivorship program is key to its success.

Overview

  • The study aimed to identify survivor and treatment characteristics associated with non-attendance at Dutch Cancer Survivorship Care (CSC) clinics for Hodgkin lymphoma (HL) survivors.
  • The study analyzed a retrospective multicenter cohort of 516 adult HL survivors invited to eight CSC clinics from 2013 to 2024.
  • The primary objective was to understand the reasons for non-attendance and identify possible improvements of the Dutch CSC for HL survivors.

Comparative Analysis & Findings

  • The attendance rate at CSC clinics was 70% (n = 363), with males being more likely to be non-attenders compared to females (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.01-2.56).
  • A history of subsequent malignancy was associated with lower odds of non-attendance (OR 0.41, 95% CI 0.19-0.89).
  • The survey conducted among non-attenders revealed that 44.8% reported surveillance or treatment for late effects elsewhere as a reason for non-attendance, while 29.5% reported an emotional burden of clinic visit.

Implications and Future Directions

  • The findings highlight the importance of active involvement of healthy (male) survivors in improving the survivorship program for its success.
  • Future research directions could involve exploring novel approaches to optimize attendance, such as telemedicine or remote consultations.
  • The study's limitations, including the retrospective design and relatively small sample size, should be addressed in future research.
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