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Impact of Diffuse Large B-Cell Lymphoma on Mammography and Bone Density Testing in Women

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Abstract

Women with diffuse large B-cell lymphoma (DLBCL) are at an increased risk of mortality from breast cancer and osteoporosis. However, the impact of DLBCL on rates of mammography and bone density testing (BDT) is unknown. We compared female DLBCL and non-cancer patients utilizing the Surveillance, Epidemiology, and End Results-Medicare dataset to analyze the predictors of mammography and BDT. Guided by the Social Ecological Model (SEM), we used multivariable logistic regressions with inverse probability treatment weighting to examine the association of intrapersonal, interpersonal, healthcare system, and community factors with mammography and BDT. The rates of mammography (59.8%) and BDT (18.5%) in women with DLBCL were similar to those without cancer (60.2% and 19.6%, respectively). After adjusting for the SEM factors, DLBCL patients were less likely to get mammography and BDT than non-cancer patients. The treatments of radiotherapy and stem cell transplant were not associated with either mammography or BDT. DLBCL diagnosis was associated with lower rates of mammography and BDT rates among women with DLBCL, as compared to non-cancer patients. To reduce the morbidity and mortality from breast cancer and fractures in women with DLBCL, providers should increase their recommendations for mammography in those receiving radiotherapy and BDT in stem cell transplant patients.

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References

  • American Cancer Society. (2019). Second cancers after Non-Hodgkin lymphoma. Retrieved Nov 24, 2020 from https://www.cancer.org/cancer/non-hodgkin-lymphoma/after-treatment/second-cancers.html.

  • Austin, P. C., & Stuart, E. A. (2015). Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Statistics in Medicine, 34(28), 3661–3679.

    Article  Google Scholar 

  • Block, L. D., Jarlenski, M. P., Wu, A. W., & Bennett, W. L. (2013). Mammography use among women ages 40–49 after the 2009 US preventive services task force recommendation. Journal of General Internal Medicine, 28(11), 1447–1453.

    Article  Google Scholar 

  • Chun, K. J. (2011). Bone densitometry. Seminars in Nuclear Medicine, 41(3), 220–228.

    Article  Google Scholar 

  • Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., & Kubik, M. (2018). Screening for osteoporosis to prevent fractures: US preventive services task force recommendation statement. JAMA, 319(24), 2521–2531.

    Article  Google Scholar 

  • DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D., Kramer, J. L., & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014. CA: A Cancer Journal for Clinicians, 64(4), 252–271.

    Google Scholar 

  • Doubeni, C. A., Field, T. S., Ulcickas Yood, M., Rolnick, S. J., Quessenberry, C. P., Fouayzi, H., & Wei, F. (2006). Patterns and predictors of mammography utilization among breast cancer survivors. Cancer, 106(11), 2482–2488.

    Article  Google Scholar 

  • Earle, C. C., Burstein, H. J., Winer, E. P., & Weeks, J. C. (2003). Quality of non-breast cancer health maintenance among elderly breast cancer survivors. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 21(8), 1447–1451. https://doi.org/10.1200/JCO.2003.03.060.

    Article  Google Scholar 

  • Earle, C. C., & Neville, B. A. (2004). Under use of necessary care among cancer survivors. Cancer, 101(8), 1712–1719.

    Article  Google Scholar 

  • Finkelstein, M. M. (2002). Preventive screening. What factors influence testing? Canadian Family Physician Medecin De Famille Canadien, 48, 1494–1501.

    PubMed  PubMed Central  Google Scholar 

  • Giordano, S. H., Kuo, Y. F., Duan, Z., Hortobagyi, G. N., Freeman, J., & Goodwin, J. S. (2008). Limits of observational data in determining outcomes from cancer therapy. Cancer: Interdisciplinary International Journal of the American Cancer Society, 112(11), 2456–2466.

    Article  Google Scholar 

  • Gourlay, M. L., Fine, J. P., Preisser, J. S., May, R. C., Li, C., Lui, L., & Ensrud, K. E. (2012). Bone-density testing interval and transition to osteoporosis in older women. New England Journal of Medicine, 366(3), 225–233.

    Article  CAS  Google Scholar 

  • Healthy People 2030. (2020). Retrieved Nov 24, 2020 from https://health.gov/healthypeople/objectives-and-data/browse-objectives

  • Hillier, T. A., Stone, K. L., Bauer, D. C., Rizzo, J. H., Pedula, K. L., Cauley, J. A., & Cummings, S. R. (2007). Evaluating the value of repeat bone mineral density measurement and prediction of fractures in older women: The study of osteoporotic fractures. Archives of Internal Medicine, 167(2), 155–160.

    Article  Google Scholar 

  • Lafata, J. E., Salloum, R. G., Fishman, P. A., Ritzwoller, D. P., O’Keeffe-Rosetti, M. C., & Hornbrook, M. C. (2015). Preventive care receipt and office visit use among breast and colorectal cancer survivors relative to age-and gender-matched cancer-free controls. Journal of Cancer Survivorship, 9(2), 201–207.

    Article  Google Scholar 

  • Leslie, W. D., Tsang, J. F., Caetano, P. A., & Lix, L. M. (2007). Effectiveness of bone density measurement for predicting osteoporotic fractures in clinical practice. The Journal of Clinical Endocrinology and Metabolism, 92(1), 77–81.

    Article  CAS  Google Scholar 

  • Li, S., Young, K. H., & Medeiros, L. J. (2018). Diffuse large B-cell lymphoma. Pathology, 50(1), 74–87.

    Article  Google Scholar 

  • Majhail, N. S., Mau, L., Denzen, E. M., & Arneson, T. J. (2013). Costs of autologous and allogeneic hematopoietic cell transplantation in the united states: A study using a large national private claims database. Bone Marrow Transplantation, 48(2), 294–300.

    Article  CAS  Google Scholar 

  • Mandelblatt, J., Saha, S., Teutsch, S., Hoerger, T., Siu, A. L., Atkins, D., & Helfand, M. (2003). The cost-effectiveness of screening mammography beyond age 65 years: A systematic review for the US preventive services task force. Annals of Internal Medicine, 139(10), 835–842.

    Article  Google Scholar 

  • Mobley, L. R., Driscoll, D., Clayton, L., & Anselin, L. (2008). Heterogeneity in mammography use across the nation: Separating evidence of disparities from the disproportionate effects of geography. International Journal of Health Geographics, 7(1), 1.

    Article  Google Scholar 

  • Mobley, L., Kuo, T. M., Urato, M., Boos, J., Lozano-Gracia, N., & Anselin, L. (2010). Predictors of endoscopic colorectal cancer screening over time in 11 states. Cancer Causes and Control, 21(3), 445–461.

    Article  Google Scholar 

  • Moore, A. R., Buchanan, N. D., Fairley, T. L., & Smith, J. L. (2015). Public health action model for cancer survivorship. American Journal of Preventive Medicine, 49(6), S470–S476.

    Article  Google Scholar 

  • Morton, L. M., Curtis, R. E., Linet, M. S., Bluhm, E. C., Tucker, M. A., Caporaso, N., & Fraumeni, J. F., Jr. (2010). Second malignancy risks after non-hodgkin’s lymphoma and chronic lymphocytic leukemia: Differences by lymphoma subtype. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 28(33), 4935–4944. https://doi.org/10.1200/JCO.2010.29.1112.

    Article  Google Scholar 

  • National Cancer Institute. (2020). Division of cancer control & population sciences. SEER-Medicare linked database. Retrieved Nov 24, 2020 from https://healthcaredelivery.cancer.gov/seermedicare/.

  • Nutting, P. A., Baier, M., Werner, J. J., Cutter, G., Conry, C., & Stewart, L. (2001). Competing demands in the office visit: What influences mammography recommendations? The Journal of the American Board of Family Practice, 14(5), 352–361.

    CAS  PubMed  Google Scholar 

  • Paccou, J., Merlusca, L., Henry-Desailly, I., Parcelier, A., Gruson, B., Royer, B., & Damaj, G. (2014). Alterations in bone mineral density and bone turnover markers in newly diagnosed adults with lymphoma receiving chemotherapy: A 1-year prospective pilot study. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 25(2), 481–486. https://doi.org/10.1093/annonc/mdt560.

    Article  CAS  Google Scholar 

  • Sanna, G., Lorizzo, K., Rotmensz, N., Bagnardi, V., Cinieri, S., Colleoni, M., & Goldhirsch, A. (2007). Breast cancer in hodgkin’s disease and non-hodgkin’s lymphoma survivors. Annals of Oncology: Official Journal of the European Society for Medical Oncology, 18(2), 288–292.

    Article  CAS  Google Scholar 

  • SEER. (2020a). Cancer Stat Facts: Non-Hodgkin’s Lymphoma. National Cancer Institute. Bethesda, MD, Retrieved Nov 24, 2020 from https://seer.cancer.gov/statfacts/html/nhl.html

  • SEER. (2020b). Cancer Stat Facts: Diffuse large B-cell lymphoma. National Cancer Institute. Bethesda, MD, Retrieved Nov 24, 2020 from https://seer.cancer.gov/statfacts/html/dlbcl.html

  • SEER. (2020c). Cancer Stat Facts: Breast cancer. National Cancer Institute. Bethesda, MD, Retrieved Nov 24, 2020 fromhttps://seer.cancer.gov/statfacts/html/breast.html

  • Smith, R. A., Andrews, K. S., Brooks, D., Fedewa, S. A., Manassaram-Baptiste, D., Saslow, D., & Wender, R. C. (2018). Cancer screening in the United States, 2018: A review of current American cancer society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians, 68(4), 297–316.

    Google Scholar 

  • Svendsen, P., Shekhrajka, N., Nielsen, K. L., Vestergaard, P., Poulsen, M. Ø., Vistisen, A. K., & Jakobsen, L. H. (2017). R-CHOP (-like) treatment of diffuse large B-cell lymphoma significantly reduces CT-assessed vertebral bone density: A single center study of 111 patients. Leukemia and Lymphoma, 58(5), 1105–1113.

    Article  CAS  Google Scholar 

  • US Department of Health and Human Services. (2019). Area health resource file (AHRF). Rockville, MD: Health Resources and Services Administration, Retrieved Nov 24, 2020 from http://ahrf.hrsa.gov/ALLVARs_search.asp

  • US Preventive Services Task Force. (2009). Screening for breast cancer: U.S. preventive services task force recommendation statement. Annals of Internal Medicine, 151(10), 716–26. https://doi.org/10.7326/0003-4819-151-10-200911170-00008.

    Article  Google Scholar 

  • Yu, X., McBean, A. M., & Virnig, B. A. (2007). Physician visits, patient comorbidities, and mammography use among elderly colorectal cancer survivors. Journal of Cancer Survivorship, 1(4), 275–282.

    Article  Google Scholar 

  • Yusuf, A. A., Hu, Y., Chandler, D., Crittenden, D. B., & Barron, R. L. (2020). Predictors of imminent risk of fracture in Medicare-enrolled men and women. Archives of osteoporosis, 15(1), 1–9.

    Article  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pharmacy Practice, College of Pharmacy, Chicago State University, Chicago, IL, 60628, USA

    Rahul Garg

  2. Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA

    Usha Sambamoorthi, Xi Tan & Kimberly M. Kelly

  3. Center for Bone Marrow Transplantation, Geisinger Medical Center, Danville, PA, 17822, USA

    Soumit K. Basu

  4. Department of Family Medicine, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA

    Treah Haggerty

  5. Robert C. Byrd Health Sciences Center, School of Pharmacy, West Virginia University Cancer Institute, PO Box 9510, Morgantown, WV, 26506, USA

    Kimberly M. Kelly

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  1. Rahul Garg
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  2. Usha Sambamoorthi
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  4. Soumit K. Basu
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Correspondence to Kimberly M. Kelly.

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Appendices

Appendix 1: Flowchart of Sample Selection for Female Medicare Beneficiaries With Diffuse Large B-Cell Lymphoma

figure a

Appendix 2: Flowchart of Sample Selection for Female Medicare Beneficiaries With No Cancer

figure b

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Garg, R., Sambamoorthi, U., Tan, X. et al. Impact of Diffuse Large B-Cell Lymphoma on Mammography and Bone Density Testing in Women. J Primary Prevent 42, 143–162 (2021). https://doi.org/10.1007/s10935-021-00621-8

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  • DOI: https://doi.org/10.1007/s10935-021-00621-8

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