abstract: Have racial disparities in ovarian cancer increased over time? An analysis of SEER data

Have racial disparities in ovarian cancer increased over time? An analysis of SEER data:

Objective 
Race has been postulated to be a prognostic factor in women with ovarian cancer. The reasons for racial disparities are multifactorial. Recent literature suggests that racial disparities in ovarian cancer survival emerged in the 1980s, when modern treatments such as aggressive surgical debulking and platinum-based chemotherapy first gained widespread use. We suspect that as improvements in treatment have evolved, the effects of access to treatment have amplified racial disparities in survival from ovarian cancer. Methods SEER 9 data were analyzed, including African American and white patients diagnosed with ovarian cancer from 1973 to 2007, with 2008 as the cutoff for follow-up. Using the Kaplan–Meier method, we evaluated racial differences in survival, to determine whether this difference has increased over time.

Results
There were 44,562 white and 3190 African American women available for analysis. Overall African Americans had 1.10 times the crude hazard (95% CI 1.06–1.15) of all-cause mortality compared to whites, with a widening trend over time (p<0.01). Adjusted for SEER registry, age, tumor stage, marital status and time of diagnosis, the hazard ratio (HR) for all-cause mortality comparing African Americans to whites was 1.31 (95% CI 1.26–1.37). When the receipt of surgery was added to the model, the HR for all-cause mortality remained higher for African American women at 1.27 (95% CI 1.21–1.34).

Conclusions 
African Americans diagnosed with ovarian cancer have worse survival than whites, and this disparity has increased over time. Measured differences in treatment, such as receipt of surgery, account for part of the disparity.

New clinical trial to determine ovarian cancer risks in African-American women

Genome.gov | 2010 Release: NIH and Wellcome Trust Announce Partnership to Support Population-based Genome Studies in Africa

Epidemiology of Ovarian Cancer in African American Women | Institute for Health Research and Policy | University of Illinois, Chicago

Principal investigator
Therese A. Dolecek, PhD
Co-investigator(s)
Faith G. Davis, PhD
Bridget McCarthy, PhD

Funding Agency
National Cancer Institute through Duke University

Start date
04/01/2010
End date
03/31/2015
Total award
$1,150,609

About this grant
This grant is a subcontract of a larger grant at Duke University.
Parent Study
Epidemiology of Ovarian Cancer in African American Women
PI of Parent Study
Joellen Schildkraut, PhD, MPH
Duke University