Abstract P065

An exploration of patient specific and systemic delays as part of the diagnostic odyssey in patients with Hodgkin lymphoma- an analysis of the Lymphoma Coalition’s 2022 Global Patient Survey

Introduction: The diagnosis of classical Hodgkin lymphoma (cHL) is complex, requiring multiple immunohistochemical markers. This may require seeking care from specialist centers which translates into sequential referrals initiating from primary care physicians. This process results in one class of diagnostic delay which we will term systemic delay (SD). Conversely, individual patients may exhibit symptoms but delay seeking medical advice for up to a year or more, which we will refer to as patient delay (PD). We sought to explore the mosaic of these different types of delays and how they contribute to the diagnostic odyssey.

Methods: The Global Patient Survey on Lymphomas & CLL was conducted in 2022 to capture the experiences of patients with lymphoma. As part of this survey, patients were asked how many healthcare professionals they had to see prior to receiving their final diagnosis (Range: 1 to more than 5). Additionally, patients were asked how long they were experiencing symptoms prior to seeking medical care (Range: < 1 month to >= 1 year). Results were cross-tabulated for analysis.

Results: Overall, 722 patients with cHL had valid responses to the questions used for this study with a median age of 36 [18 - 89]. Females comprised 68% of the study sample. Approximately half of patients (51%) sought medical care within 3 months of symptom onset while 27% waited 6 months or longer. The majority of patients (68%) received a diagnosis of cHL after seeing 1 to 3 healthcare professionals. A surprisingly large proportion of patients (19%) reported seeing 5 or more healthcare professionals before receiving their diagnosis. When looking at both SD and PD, 52% of patients receive a diagnosis within 6 months of symptom onset and with seeing 3 or fewer healthcare providers.

Conclusion: Studies have indicated that diagnostic delay has minimal adverse effect on prognosis. However, we contend that different delays may impact prognosis. Delays by the patient may indicate that symptoms are more tolerable and perhaps associated with less aggressive disease or they may be attributing symptoms to less serious diseases. Conversely, systemic delays may yield inferior outcomes, especially when coupled with delays by patient’s seeking medical care. These results indicate that improved diagnostics are warranted to simplify the diagnosis of cHL and accelerate the treatment of this disease. Also, there is room for improved symptom awareness in target populations.

Authors

Steve Kalloger, Amanda Watson, Shawn Sajkowski, Lorna Warwick