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

Huffman, Deanna; Jayakrishnan, Thejus; Shankar, Karthik; Peterson, Chelsea; Wegner, Rodney E.

doi:10.1016/j.ygyno.2021.07.011

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…Ovarian cancer is the leading cause of death among gynecological cancers and is the seventh most commonly diagnosed cancer among women around the world [ 39 ]. Black women are disproportionately affected and have higher odds of more aggressive tumor stages [ 40 ]. Ovarian cancer, despite being less common than other cancer types among women, has a low 5-year survival rate due to the advanced stage at which it is usually diagnosed; about 75% of women are diagnosed in late-stage disease and face a 5-year survival rate of about 29% [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses

Cathey,

Nguyen,

Colacino

et al. 2023

J Expo Sci Environ Epidemiol

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Background Some hormonally active cancers have low survival rates, but a large proportion of their incidence remains unexplained. Endocrine disrupting chemicals may affect hormone pathways in the pathology of these cancers. Objective To evaluate cross-sectional associations between per- and polyfluoroalkyl substances (PFAS), phenols, and parabens and self-reported previous cancer diagnoses in the National Health and Nutrition Examination Survey (NHANES). Methods We extracted concentrations of 7 PFAS and 12 phenols/parabens and self-reported diagnoses of melanoma and cancers of the thyroid, breast, ovary, uterus, and prostate in men and women (≥20 years). Associations between previous cancer diagnoses and an interquartile range increase in exposure biomarkers were evaluated using logistic regression models adjusted for key covariates. We conceptualized race as social construct proxy of structural social factors and examined associations in non-Hispanic Black, Mexican American, and other Hispanic participants separately compared to White participants. Results Previous melanoma in women was associated with higher PFDE (OR:2.07, 95% CI: 1.25, 3.43), PFNA (OR:1.72, 95% CI: 1.09, 2.73), PFUA (OR:1.76, 95% CI: 1.07, 2.89), BP3 (OR: 1.81, 95% CI: 1.10, 2.96), DCP25 (OR: 2.41, 95% CI: 1.22, 4.76), and DCP24 (OR: 1.85, 95% CI: 1.05, 3.26). Previous ovarian cancer was associated with higher DCP25 (OR: 2.80, 95% CI: 1.08, 7.27), BPA (OR: 1.93, 95% CI: 1.11, 3.35) and BP3 (OR: 1.76, 95% CI: 1.00, 3.09). Previous uterine cancer was associated with increased PFNA (OR: 1.55, 95% CI: 1.03, 2.34), while higher ethyl paraben was inversely associated (OR: 0.31, 95% CI: 0.12, 0.85). Various PFAS were associated with previous ovarian and uterine cancers in White women, while MPAH or BPF was associated with previous breast cancer among non-White women. Impact Statement Biomarkers across all exposure categories (phenols, parabens, and per- and poly- fluoroalkyl substances) were cross-sectionally associated with increased odds of previous melanoma diagnoses in women, and increased odds of previous ovarian cancer was associated with several phenols and parabens. Some associations differed by racial group, which is particularly impactful given the established racial disparities in distributions of exposure to these chemicals. This is the first epidemiological study to investigate exposure to phenols in relation to previous cancer diagnoses, and the first NHANES study to explore racial/ethnic disparities in associations between environmental phenol, paraben, and PFAS exposures and historical cancer diagnosis.

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Section: Discussionmentioning

confidence: 99%

Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses

Cathey,

Nguyen,

Colacino

et al. 2023

J Expo Sci Environ Epidemiol

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“…Charlson-Deyo comorbidity index (CCI) score was categorized as no comorbidities and one or more comorbidities. Additional covariates included tumor grade (low, intermediate, high, and unknown) histology (high-grade serous carcinoma, low-grade serous, serous NOS, clear cell, endometroid, mucinous, mixed, and other) [ 23 ]. Covariates were selected based on a priori knowledge regarding their associations with the exposure and outcome of interest.…”

Section: Methodsmentioning

confidence: 99%

Racial and socioeconomic disparities in survival among women with advanced-stage ovarian cancer who received systemic therapy

Washington,

Karanth,

Wheeler

et al. 2023

Cancer Causes Control

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Purpose The purpose of this study was to assess the association between race/ethnicity and all-cause mortality among women with advanced-stage ovarian cancer who received systemic therapy. Methods We analyzed data from the National Cancer Database on women diagnosed with advanced-stage ovarian cancer from 2004 to 2015 who received systemic therapy. Race/ethnicity was categorized as Non-Hispanic (NH) White, NH-Black, Hispanic, NH-Asian/Pacific Islander, and Other. Income and education were combined to form a composite measure of socioeconomic status (SES) and categorized into low-, mid-, and high-SES. Multivariable Cox proportional hazards models were used to assess whether race/ethnicity was associated with the risk of death after adjusting for sociodemographic, clinical, and treatment factors. Additionally, subgroup analyses were conducted by SES, age, and surgery receipt. Results The study population comprised 53,367 women (52.4% ages ≥ 65 years, 82% NH-White, 8.7% NH-Black, 5.7% Hispanic, and 2.7% NH-Asian/Pacific Islander) in the analysis. After adjusting for covariates, the NH-Black race was associated with a higher risk of death versus NH-White race (aHR: 1.12; 95% CI: 1.07,1.18), while Hispanic ethnicity was associated with a lower risk of death compared to NH-White women (aHR: 0.87; 95% CI: 0.80, 0.95). Furthermore, NH-Black women versus NH-White women had an increased risk of mortality among those with low-SES characteristics (aHR:1.12; 95% CI:1.03–1.22) and mid-SES groups (aHR: 1.13; 95% CI:1.05–1.21). Conclusions Among women with advanced-stage ovarian cancer who received systemic therapy, NH-Black women experienced poorer survival compared to NH-White women. Future studies should be directed to identify drivers of ovarian cancer disparities, particularly racial differences in treatment response and surveillance.

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“…Charlson-Deyo comorbidity index (CCI) score was categorized as no comorbidities and one or more comorbidities. Additional covariates included histology (serous carcinoma, mucinous carcinoma, endometrioid carcinoma, and other) and tumor grade (low, intermediate, high, and unknown) [23]. Covariates were selected based on a priori knowledge regarding their associations with the exposure and outcome of interest.…”

Section: Exposure Outcome and Covariatesmentioning

confidence: 99%

Racial and Socioeconomic Disparities in Survival Among Women with Advanced-stage Ovarian Cancer Who Received Systemic Therapy

Washington

Karanth

Wheeler

et al. 2023

Preprint

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Purpose The purpose of this study was to assess the association between race/ethnicity and all-cause mortality among women with advanced-stage ovarian cancer who received systemic therapy. Methods We analyzed data from the National Cancer Database on women diagnosed with advanced-stage ovarian cancer from 2004 to 2015 who received systemic therapy. Race/ethnicity was categorized as Non-Hispanic (NH) White, NH-Black, Hispanic, NH-Asian/Pacific Islander, and Other. Income and education were combined to form a composite measure of socioeconomic status (SES) and categorized into low-, mid-, and high-SES. Multivariable Cox proportional hazards models were used to assess whether race/ethnicity was associated with the risk of death. Models were adjusted for age, SES, comorbidity level, and receipt of surgery. Results The study population comprised 53,367 women (52.4% ages ≥ 65 years, 82% NH-White, 8.7% NH-Black, 5.7% Hispanic, and 2.7% NH-Asian/Pacific Islander) in the analysis. After adjusting for covariates, the NH-Black race was associated with a higher risk of death versus NH-White race (aHR: 1.12; 95% CI: 1.07,1.18), while Hispanic race was associated with a lower risk of death compared to NH-White women (aHR: 0.87; 95% CI: 0.80, 0.95). Furthermore, NH-Black women versus NH-White women had an increased risk of mortality among those with low-SES characteristics (aHR:1.12; 95% CI:1.03–1.22) and mid-SES groups (aHR: 1.13; 95% CI:1.05–1.21). Conclusions Among women with advanced-stage ovarian cancer who received systemic therapy, NH-Black women experienced poorer survival compared to NH-White women. Future studies should be directed to identify drivers of ovarian cancer disparities, particularly racial differences in treatment response and surveillance.

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

Cited by 10 publications

References 14 publications

Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses

Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses

Racial and socioeconomic disparities in survival among women with advanced-stage ovarian cancer who received systemic therapy

Racial and Socioeconomic Disparities in Survival Among Women with Advanced-stage Ovarian Cancer Who Received Systemic Therapy

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