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Effect of time on racial differences in ovarian cancer stage at diagnosis among older women identified through the National Cancer Database (1998-2012)
METHODS: NHB and NHW OVCA cases from the National Cancer Database (NCDB) were analyzed. Diagnosis stage was analyzed as early (stages I-II) and late (stages III-IV). Diagnosis year was trichotomized (1998-2002, 2003-2007, 2008-2012). Chi-square statistics tested racial differences in demographic and clinical factors (including insurance status) and stage. Multivariable logistic regression (adjusting for insurance status) estimated odds ratios (ORs) and 95% confidence intervals (95% CI) between race and late stage. Interaction between race and diagnosis period was tested in age-stratified models.
RESULTS: 137,106 (92.2%) NHW and 11,562 (7.8%) NHB were analyzed. Of those, 65,246 (43.9%) were ≥65 years. NHB women were more likely to receive late-stage diagnoses, regardless of age (≥65 years, ORadj=1.21; 95%CI=1.11-1.32; <65 years, ORadj=1.35; 95%CI 1.27-1.44). Among women <65, differences decreased over time (1998–2002: ORadj=1.51, 95%CI=1.35-1.69; 2003–2007: ORadj=1.38, 95%CI=1.24-1.54; 2008–2012; ORadj=1.19, 95%CI=1.06-1.32.) Interaction terms were significant in younger but not older women (p=0.01 and p=0.86, respectively.)
CONCLUSION: After controlling for insurance, racial differences in late-stage diagnosis decreased over time in younger but not in older women. Improving NHB-NHW stage differences over time among women <65 may represent improving healthcare, or potentially the effects of comorbidities on racial differences in diagnosis stage in older women.
Learning Areas:
Biostatistics, economicsDiversity and culture
Epidemiology
Public health or related research
Learning Objectives:
Describe racial differences in ovarian cancer stage at diagnosis in older U.S. women (<65 versus ≥65 years), using data from the National Cancer Database (NCDB).
Describe racial differences over time in older women (<65 versus ≥65 years) diagnosed with invasive epithelial ovarian cancer.
Identify the effect of time on racial differences in ovarian cancer among older women (<65 versus ≥65 years) stage at diagnosis in three periods of diagnosis (1998 – 2002, 2003 – 2007, 2008 – 2012)
Keyword(s): Cancer, Health Disparities/Inequities
Qualified on the content I am responsible for because: I am a PhD candidate in epidemiology having worked on various project related to cancer research such as the American Cancer Society(ACS) grants assessing the disparities between Whites and Blacks in colorectal and prostate cancer survival in Cook County. Now I am working on another ACS grant analyzing data from the National Cancer Database (NCDB) looking at differences between non-Hispanic black and non-Hispanic whites in ovarian cancer stage at diagnosis, treatment and survival.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.