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We described the association between patient, disease and geographic factors and first\u2010line treatment in older patients (\u226565\u00a0years) with incident HL using Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare data from 1999 to 2014 (<jats:italic>n<\/jats:italic>\u00a0=\u00a02825). First\u2010line treatment initiated at \u22644\u00a0months after diagnosis was categorised as: full chemotherapy regimen (<jats:italic>n<\/jats:italic>\u00a0=\u00a0699, 24\u00b77%); partial chemotherapy regimen (<jats:italic>n<\/jats:italic>\u00a0=\u00a01016, 36\u00b70%); single chemotherapy agent or radiotherapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a0382, 13\u00b75%); and no treatment (<jats:italic>n<\/jats:italic>\u00a0=\u00a0728, 25\u00b78%). Among the fully treated, ABVD [doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine]\/AVD was most common (<jats:italic>n<\/jats:italic>\u00a0=\u00a0635, 90\u00b78%). Adjusted multinomial logistic regression identified factors associated with treatment. Older age, Medicaid dual eligibility, not married, frailty, cardiac comorbidity, prior cancer, earlier diagnosis date, histology, advanced disease Stage, B symptoms and South region were independently associated with increased odds of not receiving full chemotherapy regimens. In conclusion, we found variability in first\u2010line HL treatment for older patients. Treatment differences by Medicaid and region may indicate disparities. Even after adjusting for frailty and cardiac comorbidity, age was associated with treatment, suggesting factors such as end\u2010of\u2010life care or shared decision\u2010making may influence treatment in older patients.<\/jats:p>","DOI":"10.1111\/bjh.16525","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T03:14:00Z","timestamp":1582514040000},"page":"222-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["First\u2010line treatment in older patients with Hodgkin lymphoma: a Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare population\u2010based study"],"prefix":"10.1111","volume":"190","author":[{"given":"Angie Mae","family":"Rodday","sequence":"first","affiliation":[{"name":"Institute for Clinical Research and Health Policy Studies Tufts Medical Center Boston MA USA"},{"name":"Department of Medicine Tufts University School of Medicine Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Hahn","sequence":"additional","affiliation":[{"name":"Roswell Park Comprehensive Cancer Center Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita J.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Institute for Clinical Research and Health Policy Studies Tufts Medical Center Boston MA USA"},{"name":"Department of Medicine Tufts University School of Medicine Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter K.","family":"Lindenauer","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Delivery and Population Science University of Massachusetts Medical School - 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