Disparities in Outcomes following Ovarian Cancer: An analysis of the
SEER database (1998-2016)
Abstract
Objectives: To determine if race/ethnicity is an independent predictor
of adverse outcomes following diagnosis of primary ovarian cancer.
Design: Retrospective study Setting: We utilized data from the
Surveillance, Epidemiology, and End Results Program (SEER) database for
this study. Population: We studied women with a primary diagnosis of
Ovarian Cancer in the SEER database between January 1998 and December
2018. Method: We utilized the nearest neighbor propensity-score matching
without replacement in a 1:1 ratio to compare mortality and overall
survival following primary ovarian cancer diagnosis between Non-Hispanic
Black (NHB) women and a control group of Non-Hispanic White (NHW) women.
These women were matched for age, treatment modalities
(surgery/irradiation/chemotherapy), laterality, and stage of cancer at
presentation. Main Outcomes: The primary outcomes of interest were
differences in mortality and survival (in months) among NHB and NHW
women Results: We compared 6,801 NHB women with 27, 204 NHW women with
primary ovarian cancer. Prior to propensity-score matching, NHB women
had a higher mortality rate (56.7%vs.53.5%, p<0.001) and
lower survival rate (40.1 vs. 48.9 months<0.001). Following
propensity-score matching, there was no difference in the mortality rate
between the two groups. (56.7% vs 55.7% p=0.13). However, NHB women
had significantly lower survival rates (40.1vs.49.6 months, p
< 0.001). Conclusion: Racial disparities in survival following
treatment for ovarian cancer persist despite adjusting for age, stage of
cancer, and treatment modalities. Further research is warranted to
explore patient and systemic factors such as appropriate level of care
and follow-up after treatment that might account for these differences.