Lammers Eline M J, Aleman Berthe M P, Schaapveld Michael, Zijlstra Josée M, Janus Cécile P M, de Weijer Roel J, Schippers Maaike G A, Boersma Rinske S, Gommers Saskia S, Kappert Mirjam, Kroeze Adriaantje C, van Leeuwen Flora E, Nijdam Annelies
Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Support Care Cancer. 2025 Jun 5;33(7):545. doi: 10.1007/s00520-025-09605-4.
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.
癌症幸存者护理（CSC）项目的参与率不理想，且对未参加的原因了解不足。为了确定荷兰霍奇金淋巴瘤（HL）幸存者CSC的可能改进措施，我们旨在：（1）确定与荷兰HL幸存者CSC诊所未就诊相关的幸存者和治疗特征；（2）评估未就诊的原因。
在一项回顾性多中心队列研究中，我们评估了2013年至2024年受邀前往8家CSC诊所的516名成年HL幸存者的就诊情况。在多变量逻辑回归分析中评估了性别、社会经济地位、CSC邀请时的年龄、HL治疗类别、心血管疾病史、后续恶性肿瘤史、自HL诊断以来的时间与未就诊之间的关联。未就诊原因来自发送给所有未就诊者的一项调查。
CSC就诊率为70%（n = 363）。在多变量分析中，男性未就诊的几率高于女性（优势比（OR）1.61，95%置信区间（CI）1.01 - 2.56），而后续恶性肿瘤史与未就诊几率较低相关（OR 0.41，95% CI 0.19 - 0.89）。在所有未就诊者中，44人（占28.8%，其中45.5%为男性）回复了调查。经常报告的未就诊原因是在其他地方进行后期影响的监测或治疗（n = 17）以及诊所就诊的情感负担（n = 15）。
我们的研究结果为提高荷兰HL幸存者CSC诊所的就诊率提供了参考。健康的（男性）幸存者积极参与幸存者项目的改进是其成功的关键。
