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abstract: (a study of the National Cancer Database)
Purpose
Previous studies assessing racial and ethnic differences in ovarian
cancer (OVCA) diagnosis stage fail to present subtype-specific results
and provide historic data on cases diagnosed between 10 and 20 years
ago. The purpose of this analysis is to assess non-Hispanic Black (NHB)
and non-Hispanic White (NHW) differences in late-stage diagnosis
including; (1) factors associated with late-stage diagnosis of invasive
epithelial OVCA overall and by histologic subtypes, (2) potential
changes across time and (3) current patterns of trends in a national
cancer registry in the USA and Puerto Rico between 1998 and 2011.
Methods
NHB
and NHW OVCA cases were derived from the National Cancer Database
(NCDB). Diagnosis stage was analyzed as a dichotomous and a four
level-category variable, respectively; early (stages I and II;
localized) versus late (stages III and IV; regional and distant) and
stages I, II, III and IV. Diagnosis period was trichotomized (1998–2002,
2003–2007, 2008–2011). Racial differences in stage were tested using ...... Interactions between race and diagnosis
period were evaluated.
Results (OR=odds ratio)
Between
1998 and 2011, 11,562 (7.8 %) NHB and 137,106 (92.2 %) NHW were
diagnosed with OVCA. In adjusted models, NHB were significantly more
likely diagnosed with late-stage OVCA than NHW (ORadj 1.26). Interaction between race and diagnosis period was marginally significant, with racial differences in stage decreasing over time (1998–2002: ORadj 1.36; 2003–2007: ORadj 1.27; 2008–2011; ORadj 1.15. NHB were also more likely to be diagnosed with stage 4 high-grade serous (ORadj 1.46), clear cell (ORadj 2.71) and mucinous (ORadj 2.78) carcinomas than NHW.
Conclusions
Racial
differences in late-stage OVCA diagnosis exist; however, these
differences are decreasing with time. Within NCDB, NHB are significantly
more likely diagnosed with late-stage OVCA and more specifically
high-grade serous, clear cell and mucinous carcinomas than NHW.
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