Racial/ethnic disparities in ovarian cancer treatment and survival

Elisa V. Bandera, Valerie S. Lee, Lorna Rodriguez-Rodriguez, C. Bethan Powell, Lawrence H. Kushi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Among patients with ovarian cancer, African American (AA)womenexperience poorer survival compared with other race/ethnicity groups. This has been attributed to differences in access to health care. Experimental Design: We evaluated racial/ethnic differences in chemotherapy dosing and survival in a cohort study among members of Kaiser Permanente Northern California, and thus with equivalent access to health care. Analyses included epithelialinvasive ovarian cancer cases (n = 793) receiving adjuvant firstline therapy of carboplatin and paclitaxel with curative intent, withmedian follow-up of50months. Relativedose intensity(RDI) was computed for carboplatin and paclitaxel separately as dose administered per week divided by expected dose per week, and average RDI (ARDI) was then calculated for the regimen. Proportional hazards regression was used to calculate HRs and 95% confidence intervals (CIs) after adjusting for relevant covariates. Results: Compared with whites, AAs were more likely to have dose reduction (ARDI < 85%), treatment delay, and early discontinuation. Hispanics were also more likely to have dose reduction, but less likely to have early discontinuation or treatment delay. After controlling for prognostic factors including ARDI, AA women had the worst survival. Compared with whites, adjusted HRs (95% CI) for overall mortality were 1.56 (1.01-2.39) for AAs; 0.89 (0.61-1.31) for Asians; and 1.41 (0.98-2.04) for Hispanics. Findings for ovarian cancer-specific mortality were similar. Conclusions: Disparities in ovarian cancer treatment and survival in AA persisted among women with equal access to care. These findings warrant further evaluation of biological, personal, and social factors that may be responsible for these differences. Clin Cancer Res; 22(23); 5909-14.

Original languageEnglish (US)
Pages (from-to)5909-5914
Number of pages6
JournalClinical Cancer Research
Volume22
Issue number23
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

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Ovarian Neoplasms
African Americans
Health Services Accessibility
Survival
Carboplatin
Paclitaxel
Hispanic Americans
Confidence Intervals
Mortality
Therapeutics
Cohort Studies
Research Design
Drug Therapy
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Bandera, E. V., Lee, V. S., Rodriguez-Rodriguez, L., Powell, C. B., & Kushi, L. H. (2016). Racial/ethnic disparities in ovarian cancer treatment and survival. Clinical Cancer Research, 22(23), 5909-5914. https://doi.org/10.1158/1078-0432.CCR-16-1119

Racial/ethnic disparities in ovarian cancer treatment and survival. / Bandera, Elisa V.; Lee, Valerie S.; Rodriguez-Rodriguez, Lorna; Powell, C. Bethan; Kushi, Lawrence H.

In: Clinical Cancer Research, Vol. 22, No. 23, 01.12.2016, p. 5909-5914.

Research output: Contribution to journalArticle

Bandera, EV, Lee, VS, Rodriguez-Rodriguez, L, Powell, CB & Kushi, LH 2016, 'Racial/ethnic disparities in ovarian cancer treatment and survival', Clinical Cancer Research, vol. 22, no. 23, pp. 5909-5914. https://doi.org/10.1158/1078-0432.CCR-16-1119
Bandera EV, Lee VS, Rodriguez-Rodriguez L, Powell CB, Kushi LH. Racial/ethnic disparities in ovarian cancer treatment and survival. Clinical Cancer Research. 2016 Dec 1;22(23):5909-5914. https://doi.org/10.1158/1078-0432.CCR-16-1119
Bandera, Elisa V. ; Lee, Valerie S. ; Rodriguez-Rodriguez, Lorna ; Powell, C. Bethan ; Kushi, Lawrence H. / Racial/ethnic disparities in ovarian cancer treatment and survival. In: Clinical Cancer Research. 2016 ; Vol. 22, No. 23. pp. 5909-5914.
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AB - Purpose: Among patients with ovarian cancer, African American (AA)womenexperience poorer survival compared with other race/ethnicity groups. This has been attributed to differences in access to health care. Experimental Design: We evaluated racial/ethnic differences in chemotherapy dosing and survival in a cohort study among members of Kaiser Permanente Northern California, and thus with equivalent access to health care. Analyses included epithelialinvasive ovarian cancer cases (n = 793) receiving adjuvant firstline therapy of carboplatin and paclitaxel with curative intent, withmedian follow-up of50months. Relativedose intensity(RDI) was computed for carboplatin and paclitaxel separately as dose administered per week divided by expected dose per week, and average RDI (ARDI) was then calculated for the regimen. Proportional hazards regression was used to calculate HRs and 95% confidence intervals (CIs) after adjusting for relevant covariates. Results: Compared with whites, AAs were more likely to have dose reduction (ARDI < 85%), treatment delay, and early discontinuation. Hispanics were also more likely to have dose reduction, but less likely to have early discontinuation or treatment delay. After controlling for prognostic factors including ARDI, AA women had the worst survival. Compared with whites, adjusted HRs (95% CI) for overall mortality were 1.56 (1.01-2.39) for AAs; 0.89 (0.61-1.31) for Asians; and 1.41 (0.98-2.04) for Hispanics. Findings for ovarian cancer-specific mortality were similar. Conclusions: Disparities in ovarian cancer treatment and survival in AA persisted among women with equal access to care. These findings warrant further evaluation of biological, personal, and social factors that may be responsible for these differences. Clin Cancer Res; 22(23); 5909-14.

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