Older black women do not receive chemotherapy as often as white women after ovarian cancer surgery

2009 ◽  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
White Women ◽  
Cancer Surgery

scholarly journals An Assessment of Ovarian Cancer Histotypes Across the African Diaspora

2021 ◽  
Vol 11 ◽  
Author(s):  
Sophia H. L. George ◽  
Ayodele Omotoso ◽  
Andre Pinto ◽  
Aisha Mustapha ◽  
Alex P. Sanchez-Covarrubias ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
African Diaspora ◽  
White Women ◽  
Population Based ◽  
International Agency ◽  
Data Systems ◽  
African Countries ◽  
Cancer Data ◽  
Ovarian Cancers

ObjectiveOvarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora.MethodsPatients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student’s t-test with significance set at p<0.05.ResultsNigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p<0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p<0.01).ConclusionThere is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.

Racial disparities in ovarian cancer survival in New York state.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5579-5579
Author(s):  
Sarah Madhu Temkin ◽  
Zhaomin Xu ◽  
Carla Francesca Justiniano ◽  
Adan Z Becerra ◽  
Christopher Thomas Aquina ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
New York ◽  
Black Women ◽  
Marital Status ◽  
Racial Disparities ◽  
White Women ◽  
New York State ◽  
Median Income ◽  
York State ◽  
Black And White

5579 Background: Disparities between black and white patients are well documented in gynecologic cancers but information on the contributions of social factors and medical comorbidities is sparse. We examined differences in outcomes amongst black and white women with ovarian cancer in New York State. Methods: Patients with incident ovarian cancer in the New York State Cancer Registry and the Statewide Planning and Research Cooperative System from 2006-2013 were included. Differences in social and demographic factors, comorbidities and tumor characteristics between black and white women were examined with bivariate analysis. Multivariable analyses were used to examine factors associated with specific treatments and survival. Results: Of 5969 patients, 87% were white and 13% black. Age, Hispanic ethnicity and median income were similar between groups. Black women were less likely to be married (27 vs 48%, p < 0.01); and less likely to be privately insured (20 vs 50%, p < 0.01). More black women had comorbidities by Charlson Comorbidity Index (CCI) (63 vs 51%, p < 0.01). Black women were more likely to have Stage IV disease and non-serous histology (p < 0.01). More black women were treated at academic medical centers (67 vs 50%, p < 0.01). Marital status, insurance, CCI, stage, histology and treatment site correlated to the type of treatment received (p < 0.01). Black women received different treatment and had higher odds of receiving no treatment 1.63 (1.24, 2.14); chemotherapy without surgery 1.26 (1.00, 1.59); lower odds of undergoing primary surgical management 0.71 (0.58, 0.86) or chemotherapy following surgery 0.79 (0.66, 0.96; and similar rates of neoadjuvant chemotherapy. The risk of 5 year mortality was 1.14 (1.02, 1.27) times higher for black women compared with whites. Marital status, CCI, stage and histology correlated with overall and disease specific survival among both black and white women (p < 0.01). Conclusions: Multiple factors, including race, are associated with receipt of treatment and survival in ovarian cancer. Treatment for ovarian cancer was significantly different amongst black women than white in New York State. Understanding modifiable influences on racial disparities is imperative to reducing race based differences in outcomes.

Racial disparities in receipt of guideline care and cancer deaths for women with ovarian cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18081-e18081 ◽  
Author(s):  
Joan Warren ◽  
Kathleen A Cronin ◽  
Jennifer Stevens ◽  
Nadia Howlader ◽  
Edward Lloyd Trimble ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
White Women ◽  
Cohort Analysis ◽  
Stage Iv ◽  
Stage Iii ◽  
Teaching Hospitals ◽  
Risk Of Death ◽  
Guideline Care ◽  
Black Patients

e18081 Background: Receipt of guideline care improves survival for women with ovarian cancer yet care may vary by race. We assessed the receipt of guideline care and cancer deaths by race for women with incident ovarian cancer. Methods: This retrospective cohort analysis used the National Cancer Institute’s Patterns of Care data for black and white women diagnosed with all stages of ovarian cancer in 2002 and 2011 (n = 5356) with follow-up through 12/31/14. Data included patient characteristics, type of surgery and chemotherapy, and provider factors. Multivariate logistic regression was used to create the standardized percentages (predictive margins) of women receiving guideline treatment by race group. Cox proportional hazards models were used to assess the unadjusted and adjusted risk of ovarian cancer death by race. Results: At diagnosis, for black women, 35.6% had Stage III and 37.2% had Stage IV disease compared with 44.1% Stage III and 24.2% Stage IV for white women. More black women had surgery in large teaching hospitals (47.6%) than white women (39.7%) but use of gynecologic oncologists (GO) was similar for black women and white women- (62.1% vs 58.8%). In regression models, the standardized percent of black women receiving guideline care was significantly lower than for white women (29.2% vs 38.5%). The unadjusted hazards ratio (HR) for death was significantly higher in black women (HR = 1.32) yet after controlling for patient and provider factors and receipt of guideline care, black women did not have a significantly higher risk of death (HR = 1.08). Conclusions: Rates of guideline care are very low for all women with ovarian cancer, significantly more so for black patients. Low use of guideline care among black women cannot be explained by provider factors as a large percent of black women consulted a GO or received care in large teaching hospitals. Research is needed to address how to increase guideline care among black patients as we found that race was not associated with the risk of death when guideline care was included as a factor in multivariate survival models.

Disparities in ovarian cancer treatment and overall survival according to race: An update.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5552-5552
Author(s):  
Deanna Huffman ◽  
Thejus Thayyil Jayakrishnan ◽  
Karthik Shankar ◽  
Chelsea Peterson ◽  
Rodney E. Wegner
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Black Women ◽  
White Women ◽  
Disease Stage ◽  
Black Race ◽  
Nccn Guidelines ◽  
Socioeconomic Characteristics ◽  
Black Patients ◽  
White Patients

5552 Background: It has long been identified that black women with ovarian cancer have worse overall survival when compared to white women. Disparities in the adherence to NCCN guideline-directed treatment and socioeconomic characteristics may be responsible for the differences in these outcomes. Methods: A retrospective review of National Cancer Database (NCDB) was performed to identify patients diagnosed with ovarian cancer from 2012-2016. We defined adherence to NCCN (National Comprehensive Cancer Network) guidelines as having stage and year-appropriate chemotherapy and surgery. Differences in guideline adherence, socioeconomic characteristics and survival outcomes were assessed. Results: In total, 32,163 were identified meeting the study criteria; 27,744 identified their race as “white” and 2,204 identified their race as “black”. Characteristics associated with higher likelihood of black race were advanced stage of disease- stage III (OR = 1.1869, CI = 1.03-1.37) or stage IV disease (OR = 1.4495, CI = 1.23-1.70) and treatment in a comprehensive (OR = 1.5757, CI = 1.16-2.15) or academic (OR = 2.3023, CI = 1.70-3.12) treatment facility. Variables associated with a lower likelihood of black race were higher education level (OR for high school degree < 6.5 % = 0.2501, CI = 0.21-0.30) and higher median household income (OR for income > $63,333 = 0.4218, CI = 0.36-0.49). Whether the care received was adherent to NCCN guidelines did not seem to be associated with black race (OR for adherence = 1.0021, CI = 0.89-1.13). 5-year overall survival for patients who received adherent care was 58% for white patients vs. 49% for black patients. Among those who didn’t receive adherent care, the outcomes were 49% among white patients vs. 38% among black patients. Conclusions: Overall survival remains worse for black patients, regardless of whether their care adhered to NCCN guidelines as defined by our study. This suggests that while receipt of care that is not adherent to NCCN guidelines seems to be negatively associated with overall survival, we must consider and evaluate other socioeconomic, environmental and system factors that are contributing to this continued survival discrepancy in women being treated for ovarian cancer.

Association between utilization patterns and racial disparities in hospice enrollment among women dying of ovarian cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 142-142
Author(s):  
Megan Mullins ◽  
Shitanshu Uppal ◽  
Michele L. Cote ◽  
Philippa Clarke ◽  
Julie J. Ruterbusch ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
White Women ◽  
Ethnic Disparities ◽  
Outpatient Setting ◽  
Inpatient Setting ◽  
Outpatient Management ◽  
Goals Of Care ◽  
Race Ethnicity ◽  
Hispanic White

142 Background: Goals of care conversations are associated with less aggressive end of life care and may be most effective in an outpatient setting. Yet, the relationship between initial utilization of care and subsequent hospice enrollment is unknown. We evaluated whether inpatient, outpatient and emergency department (ED) evaluation and management (E/M) visits differed by patient race/ethnicity, and whether less outpatient management was associated with failure to enroll in hospice in a sample of women dying of ovarian cancer. Methods: Women diagnosed with first and only ovarian cancer who died between 2000 and 2016 and had ≥ one inpatient and outpatient ovarian cancer E/M encounter between diagnosis and the last two months of life in SEER-Medicare were included (N = 8,806). Women whose proportion of outpatient E/M encounters fell below the median were classified as having low outpatient management (vs. high). Multivariable-adjusted logistic regression was used to estimate the association of: (1) race/ethnicity with outpatient management, and (2) outpatient management with hospice enrollment, stratified by race/ethnicity. Models were adjusted for stage at diagnosis, histology, survival time, age, Charlson score, geographic region, and year. Results: In this sample, 29.2% of ovarian cancer E/M took place in an inpatient setting, 66.4% outpatient, and 4.4% in the ED. Non-Hispanic Black women had 53.9% of their E/M occur in an outpatient setting, compared to 67.6% in non-Hispanic White women, 60.7% in Hispanic women, and 64.2% in women of other races (p <.001). Black women had 78% greater odds of low outpatient management when compared to non-Hispanic White women (adjusted OR 1.78, 95%CI: 1.46-2.18). Women with low (vs. high) outpatient management had 33% greater odds of not enrolling in hospice (adjusted OR 1.33, 95%CI: 1.20-1.48). The association of low outpatient management with not enrolling in hospice was most pronounced among Black women (Black adjusted OR: 1.54, 95%CI: 1.02-2.32 vs. Non-Hispanic White adjusted OR: 1.32, 95%CI: 1.18-1.48). Conclusions: Although most ovarian cancer care takes place in an outpatient setting, Black women have the lowest proportion of outpatient care, and low outpatient management was associated with not enrolling in hospice. When deploying interventions to improve goals of care conversations for women with ovarian cancer, racial/ethnic disparities in care settings must be considered.

Ethnic Differences in Self-Poisoning Across South London

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 268-272
Author(s):  
Sean Cross ◽  
Dinesh Bhugra ◽  
Paul I. Dargan ◽  
David M. Wood ◽  
Shaun L. Greene ◽  
...  
Keyword(s):  
Black Women ◽  
Data Collection ◽  
White Women ◽  
Population Based ◽  
Care Services ◽  
Self Harm ◽  
Managing Risk ◽  
The Uk ◽  
Incident Cases ◽  
Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

Race, Gender, and Perceived Employment Discrimination

2021 ◽  
Vol 52 (5) ◽  
pp. 509-527
Author(s):  
Philip Q. Yang
Keyword(s):  
Black Women ◽  
White Women ◽  
Social Inequalities ◽  
Employment Discrimination ◽  
General Social Survey ◽  
Self Report ◽  
Independent Effect ◽  
Race And Gender ◽  
Job Discrimination ◽  
And Gender

This study investigates the effects of race and gender on perceived employment discrimination using the 2016 General Social Survey that provides new data on perceived employment discrimination that aligns more closely with the legal definition of employment discrimination. It is found that 19% of the American adults self-reported the experience of employment discrimination in job application, pay increase, or promotion in the past 5 years. The results of logistic regression analysis show that either controlling or not controlling for other factors, Blacks were much more likely to perceive being discriminated in employment than Whites, but other races were not significantly different from Whites in perceived employment discrimination after holding other variables constant. While gender did not have a significant independent effect on perceived job discrimination, it did interact with race to influence perceived job discrimination. Regardless of race, women were somewhat less likely than men to perceive job discrimination, but Black women were significantly even less likely than White women to self-report job discrimination, and Black men were much more likely to self-report employment discrimination than White men. These findings have implications for combating employment discrimination and addressing social inequalities.

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

Discordance Between Perinatal Alcohol Use Among Women and Provider Counseling for Alcohol Use: An Assessment of the Pregnancy Risk Assessment Monitoring System

2021 ◽  
pp. 003335492098414
Author(s):  
Erika L. Thompson ◽  
Tracey E. Barnett ◽  
Dana M. Litt ◽  
Erica C. Spears ◽  
Melissa A. Lewis
Keyword(s):  
Black Women ◽  
Alcohol Use ◽  
Universal Screening ◽  
White Women ◽  
Hispanic Women ◽  
Pregnancy Risk ◽  
Health Insurance Status ◽  
Prenatal Alcohol Use ◽  
Prenatal Alcohol ◽  
Alcohol Counseling

Objective In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women. Methods State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome. Results Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status. Conclusion Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.

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