title: Impact of cardiovascular counseling and screening in Hodgkin lymphoma survivors.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction.
  
  
  METHODS
  Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening.
  
  
  RESULTS
  Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD.
  
  
  CONCLUSIONS
  Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by means of CTA and subsequent cardiac intervention was highly valued, and the benefits were felt to outweigh the emotional and practical burden.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: l.a.daniels@lumc.nl.
authors.forename: Laurien A
authors.initials: LA
authors.lastname: Daniëls
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Stijn D G
authors.initials: SD
authors.lastname: Krol
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Michiel A
authors.initials: MA
authors.lastname: de Graaf
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Arthur J H A
authors.initials: AJ
authors.lastname: Scholte
authors.affiliation: Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Mars B
authors.initials: MB
authors.lastname: van 't Veer
authors.affiliation: Department of Medical Statistics and Bio-informatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.affiliation: Research Department Comprehensive Cancer Center South, Eindhoven, The Netherlands; Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000523:psychology; D058070:Asymptomatic Diseases / Q000523:psychology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000523:psychology / Q000628:therapy; D017023:Coronary Angiography / Q000379:methods / Q000523:psychology; D003376:Counseling; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006689:Hodgkin Disease / Q000523:psychology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult