Non-Hispanic Black (NHB) patients are less likely than Hispanic or non-Hispanic White (NHW) patients to receive guideline-recommended treatment for ovarian cancer, according to research published in the Journal of the National Comprehensive Cancer Network.
These differences were only partly explained by disparities in health care access, researchers found.
The team evaluated data from 5632 patients from the SEER-Medicare database who were diagnosed with ovarian cancer between 2008 and 2015. Most patients (88.4%) were NHW, 5.9% were NHB, and 5.6% were Hispanic.
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NHB patients were less likely to receive guideline-concordant systemic therapy, when compared with NHW or Hispanic patients — 74%, 81%, and 84%, respectively (P <.005).
Overall, 24% of NHW and Hispanic patients received guideline-concordant surgery and completed all recommended chemotherapy, compared with 14% of NHB patients.
These disparities could be partly explained by different dimensions of health care access, according to the researchers. The dimensions of health care access analyzed included affordability (the ability to pay for care), availability (type, quality, and volume of services), and accessibility (geographic location of services).
In fully-adjusted models, undergoing guideline-concordant surgery was significantly associated with higher affordability (risk ratio [RR], 1.05; 95% CI, 1.01-1.08) and availability (RR, 1.06; 95% CI, 1.02-1.10) but not accessibility (RR, 1.04; 95% CI, 0.98-1.11).
Receipt of systemic therapy was associated with higher affordability (hazard ratio [HR], 1.09; 95% CI, 1.05-1.13) but not availability (HR, 1.03; 95% CI, 0.99-1.08) or accessibility (HR, 1.03; 95% CI, 0.97-1.10).
NHB patients were significantly less likely than NHW patients to receive systemic therapy in an analysis adjusted for health care access dimension scores, demographics, and clinical characteristics (HR, 0.86; 95% CI, 0.75-0.99). There was no significant difference between Hispanic and NHW patients, however.
There was no significant difference between NHB, NHW, or Hispanic patients for the likelihood of undergoing surgery in an analysis adjusted for health care access dimension scores, demographics, and clinical characteristics.
The researchers concluded that, although health care access dimensions can predict receipt of guideline-concordant treatment, they “do not fully explain” racial/ethnic disparities observed in the treatment of patients with ovarian cancer.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Montes de Oca MK, Wilson LE, Previs RA, et al. Healthcare access dimensions and guideline-concordant ovarian cancer treatment: SEER-Medicare analysis of the ORCHiD study. J Natl Compr Canc Netw. 2022;20(11):1255-1266.e11. doi:10.6004/jnccn.2022.7055
