Source: Urology  |  Posted 5 years ago

By Ed Susman

PHILADELPHIA, PA -- November 8, 2006 -- Survivors of Hodgkin's disease who have an increased risk of heart disease should be screened for cholesterol at least every 5 years following curative treatment, researchers said here at the American Society for Therapeutic Radiology and Oncology (ASTRO) 48[^]th[] annual meeting.

The modeling study was based on costs of screening for cholesterol levels and of treating with cholesterol-lowering statin drugs. The findings indicated that such a program would cost $29,000 per quality year of life saved for women and $19,000 per quality year of life saved for men, said lead investigator Aileen Chen, MD, senior resident in radiation oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

Dr. Chen estimated that about 8,000 people a year suffer Hodgkin's disease, but as many as 90% of these individuals are cured of their disease through use of chemotherapy and radiation.

"That means there are a lot of people who are survivors of this disease, and we know that they have a greater risk of heart disease, possibly due to their treatments that cured them of the cancer," she said.

"People who survive Hodgkin's disease in their 20s are at 3 times the risk of heart disease later in life," said Dr. Chen in her presentation on November 8th. "We found in our modeling study that it would be well within what we generally consider cost effective to screen and treat these individuals with cholesterol-lowering drugs. In the United States we consider that a $50,000 to $100,000 per quality year of life saved as being the benchmark for cost-effectiveness, so clearly these figures fall into this category."

Najeeb Mohideen, MD, associate medical director, Northwest Community Hospital, Arlington heights, Illinois, a spokesperson for ASTRO, commented on the study, saying that some drugs used in Hodgkin's disease chemotherapy treatment have adverse cardiovascular effects. "A number of people also received radiation to the chest to defeat Hodgkin's disease and that radiation can impact t the heart and the arteries in the cardiovascular system," he said.

Dr. Mohideen, who did not participate in the study, said the radiation could damage some of the blood vessels and those arteries could be adversely affected by cholesterol levels.

Testing individuals for cholesterol is relatively inexpensive, Dr. Chen said, but treating people with somewhat expensive statin drugs that lower cholesterol drive up the costs. "However, if some of the drugs go off patent and become generic, the costs could be a lot lower," she said.

While Dr. Chen's work is based on statistical modeling, Dr. Mohideen said the information derived from her work could impact clinical practice. "I think I would use this information," he said. "We should check lipid profiles and intervene if those cholesterol levels are a problem."

Dr. Chen said that her figures were based on cholesterol testing being performed every 5 years after completing anti-cancer treatment. Testing more frequently, she said, would drive up the costs, but would probably save more years of life.

[Presentation title: Cost Effectiveness of Lipid Screening in Hodgkin's Disease Survivors. Abstract 168]