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APHA Scientific Session and Event Listing

Daniel P. Kelly, BS, Brown Medical School, Brown University, Campus Box G-8227, Providence, RI 02912, 401-447-8926, Daniel_Kelly@brown.edu, Sherry Weitzen, PhD, Division of Research, Women and Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905, and Paul DiSilvestro, MD, Program in Women's Oncology, Women and Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905.

Introduction: Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy in the nation. Survival correlates with stage of disease at diagnosis. Nationally, over 65% of women are diagnosed at late stages. Data suggests gynecologic oncologist care improves survival. We sought to characterize demographic variables influencing stage at diagnosis and survival, including effects of residence and travel time to specialty care among RI women diagnosed with EOC. Methods: We conducted a retrospective cohort study of 450 RI women diagnosed and/or treated between 1991-2004 for EOC at Women and Infants' Hospital, the only facility in RI offering gynecologic oncology services. Outcomes were stage at diagnosis (early vs. late) and vital status. Data was collected for age, insurance, and reception of routine care prior to diagnosis. Location of residence was defined as county, travel time to specialty care, and Health Service Areas (HSA). Results: There was no difference in risk of late stage diagnosis or death by location of residence. Women age 60 years or older at diagnosis were more likely to be diagnosed with late stage disease (RR: 1.28; 1.11-1.47) and were more likely to die (RR: 1.60; 1.32-1.94) than women less than 60 years old. Women who received regular medical care prior to diagnosis had reduced risk of death (RR: 0.57, 0.48-0.68). Conclusions: Among RI women seeking gynecologic oncology care for EOC, location of residence did not influence stage at diagnosis or survival. Regular medical care prior to diagnosis correlated with earlier stage diagnosis and increased survival.

Learning Objectives: At the end of the presentation, participants will be able to

• Identify variables affecting stage of disease and survival of women diagnosed with epithelial ovarian cancer.;
• Determine the influence of tertiary gynecologic oncology care on outcomes in ovarian cancer.; and
• Assess the effects of not receiving routine health care on diagnosis and prognosis of ovarian cancer.

Keywords: Cancer, Access to Care

Presenting author's disclosure statement:

Any relevant financial relationships? No