Ovarian Cancer Disparity in Advanced Stage Diagnosis and Surgery Treatment: Multilevel Analysis of SEER 2001-2011 Data
Methods: Surveillance, Epidemiology, and End Results (SEER) 13 data (2001-2011) were analyzed. Multilevel and multivariate logistic regression models were used to evaluate the disparities in ovarian cancer diagnosis and treatment adjusting for age, tumor pathological characteristics, marital status, insurance status, rural residency, county level socioeconomic characteristics, and year of diagnosis.
Result: 20,901 patient observations were analyzed. Compared to non-Hispanic white women, non-Hispanic black women were 1.22 (95% CI: 1.04-1.43) times more likely to have advanced stage diagnosis (p=0.015) and were 62% (95% CI: 0.31-0.47) less likely to receive surgery (p<0.001). Hispanics were 2.16 times more likely to receive surgery than non-Hispanic blacks (95% CI: 1.65-2.84, p<0.001). There was no significant difference in diagnosis and receipt of surgery between Hispanics and non-Hispanic whites. Individual-level factors contributing to racial disparities included marital status and health insurance. County-level socioeconomic characteristics and rural residence were not significantly associated with diagnosis and surgery treatment by race/ethnicity.
Conclusion: While racial/ethnic disparity in ovarian cancer diagnosis and treatment is not driven by contextual-level factors examined in this study, observed geographic variation in surgery treatment warrants further attention in disparities research. Elucidating which individual- and contextual-level factors in addition to those examined in this study explain the geographic variation may inform intervention development to reduce ovarian cancer disparities.
Learning Areas:Assessment of individual and community needs for health education
Diversity and culture
Social and behavioral sciences
Identify factors which contribute to racial/ethnic disparity in ovarian cancer diagnosis and receipt of surgery treatment Explain mechanisms through which ovarian cancer racial disparities are developed Identify subpopulations who suffer an excessive ovarian cancer burden.
Keyword(s): Cancer and Women’s Health, Health Disparities/Inequities
Qualified on the content I am responsible for because: This is research I conducted as a doctoral student.
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.