This article is more than 5 years old. Information may no longer be current.
Racial, socioeconomic factors predicted outcomes in ovarian cancer
Click Here to Manage Email Alerts
Black women were less likely than white women to receive guideline-based care for ovarian cancer, according to recent findings.
Robert E. Bristow, MD, MBA, FACS, director of gynecologic oncology services at UC Irvine Healthcare, and colleagues conducted a population-based analysis of National Cancer Data Base (NCDB) records to determine whether racial and socioeconomic status disparities affected the quality of epithelial ovarian cancer care and survival outcomes in a cohort of 47,160 women.
Robert E. Bristow
Eligible participants were diagnosed between 1998 and 2002.
The primary outcome measure was adherence to National Comprehensive Cancer Network guidelines for recommended procedures and therapy. OS by race and socioeconomic status also served as primary endpoints.
The analysis included 43,995 white women and 3,165 black women.
Failure to adhere to NCCN care guidelines independently predicted worse OS (HR=1.43; 95% CI, 1.38-1.47).
Black race (OR=1.36; 95% CI, 1.25-1.48), Medicare payer status (OR=1.20; 95% CI, 1.12-1.28), and not insured payer status (OR=1.33; 95% CI, 1.19-1.49) independently predicted a higher likelihood of not receiving recommended care.
The researchers also conducted an analysis that controlled for disease and treatment-related variables. Results of this analysis indicated that survival was predicted by four independent racial and socioeconomic factors: black race (HR=1.29; 95% CI, 1.22-1.36), Medicaid payer status (HR=1.29; 95% CI, 1.20-1.38), not insured payer status (HR=1.32; 95% CI, 1.20-1.44) and median household income less than $35,000 (HR=1.06; 95% CI, 1.02-1.11).
“These data highlight and quantify clinically significant disparities in the quality of ovarian cancer care and overall survival, independent of NCCN guidelines, along racial and socioeconomic status parameters in the United States and indicate that not all segments of the population have benefitted equally from improvements in ovarian cancer care,” Bristow and colleagues concluded. “Increased efforts are needed to more precisely define the patient, provider, health care system and societal factors leading to these observed disparities and develop an informed platform from which targeted interventions can be designed to reduce and ultimately eliminate ovarian cancer disparities among persons from all racial groups and socioeconomic strata.”
Click Here to Manage Email Alerts