Last Updated: 2009-10-09 11:00:24 -0400 (Reuters Health)

By Scott Baltic

NEW YORK (Reuters Health) - Routine lipid screening, followed by treatment with statins when necessary, can likely reduce cardiac-related deaths in people who have survived Hodgkin's lymphoma after receiving mediastinal irradiation.

Moreover, regardless of the cost of statin therapy, the screening is also cost-effective, US researchers report in the September 14th online issue of the Journal of Clinical Oncology.

Although mediastinal radiation is a key risk factor for cardiovascular disease in Hodgkin's survivors, traditional cardiac risk factors, such as high cholesterol levels, also contribute to the risk.

"Routine follow-up and screening for late effects of treatment are important for long-term survivors of Hodgkin lymphoma," Dr. Aileen Chen of Dana-Farber Cancer Institute, Boston, told Reuters Health. "Patients treated with radiation to the chest are at increased risk of cardiac disease, and based on our model, we recommend lipid screening once every three years for the average patient."

The researchers noted that the screening interval should be based on individual circumstances, possibly with more-frequent screening for survivors thought to be at higher risk.

Their study used a mathematical model based on a hypothetical group of 30-year-old patients with Hodgkin's lymphoma who survived 5 years after mediastinal irradiation. The simulation compared the options of no screening versus screening at 1-, 3-, 5- and 7-year intervals.

The model assumed that patients would be treated as necessary with the most commonly prescribed statin; the cost of such treatment was taken in part from 2006 Medicare fee schedules.

Using an incremental cost-effectiveness ratio threshold of $100,000 per quality-adjusted life-year saved, the most cost-effective approach was lipid screening every three years. However, all of the screening intervals were found to be cost effective relative to no screening.

In addition to improving overall survival in these hypothetical individuals, screening every three years also lengthened both overall life expectancy and quality-adjusted life expectancy.

J Clin Oncol 2009.