LDCT Detects New Cancers in Hodgkin Lymphoma Survivors

Low-dose CT screening of Hodgkin lymphoma (HL) survivors may detect early-stage, resectable cancers, according to a study published in the International Journal of Radiation Oncology.

Researchers from Harvard University, the Dana-Farber Cancer Institute and the University of Toronto undertook a study to determine the merits of annual low-dose CT screening among these patients. 

The researchers used population databases and medical literature specific to HL, looking at lung cancer rates, stage distribution, cause specific survival estimates and utilities. They also assessed radiation therapy (RT) technique used during treatment; smoking status (if the survivors smoked more than 10 pack-years, were current smokers or non-smokers); age when HL was diagnosed; time from HL treatment and excess radiation from low-dose CTs.

The results showed that while the cost effectiveness may not have been apparent among non-smokers, it was among all smokers. “A male smoker treated with mantle RT at age 25 achieved maximum quality-adjusted life years (QALYs) by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY,” the authors wrote. However, the annual screening only produced a QALY benefit among some smokers, “but the incremental cost was not below the WTP threshold for any patient subsets.”

The researchers also found that the age at HL diagnosis affected the findings because earlier initiation of screening improved outcomes. As well, lung cancer incidence and mortality rates were the most sensitive of the analyses.

Because of their increased risk for cancer later in life, HL survivors may benefit from low-dose CT screening, particularly if they were or are smokers, the researchers concluded.