Population-Based Analysis of Patient Age and Other Disparities in the Treatment of Ovarian Cancer in Central Appalachia and Kentucky

Ore, R.M.; Chen, Quan; DeSimone, Christopher P.; Miller, Rachel W.; Baldwin, Lauren; Nagell, J.R. van; Huang, Bin; Tucker, T. C.; Johnson, Marian S.; Fredericks, Tricia; Ueland, Frederick R.

doi:10.14423/smj.0000000000000821

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…3,[9][10][11][12][13] Despite the evidence of improved outcomes and NCCN recommendations, as many as 30% of women with ovarian cancer in the United States and nearly 15% of women in Iowa are not receiving surgical care from a gynecologic oncologist. 11,[14][15][16][17][18][19][20] Researchers have hypothesized this discrepancy between recommended and received care is due to the incidental diagnosis, discovery of cancer during non-cancer surgery and disagreement about standards of care. 21,22 Low referral rates may also be associated with receipt of care at a rural hospital or a low-volume hospital, and lower patient income or a lack of insurance.…”

Section: Introductionmentioning

confidence: 99%

Patient and Provider Perspectives on Barriers to Accessing Gynecologic Oncologists for Ovarian Cancer Surgical Care

Weeks

West

Lynch

et al. 2020

Women's Health Reports

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Objective: National Comprehensive Cancer Network (NCCN) guidelines recommend that patients with ovarian cancer receive surgical care from a gynecologic oncologist. However, 15%–30% of patients with ovarian cancer do not receive surgical care from this specialist. The reasons for this remain unknown. We aim at assessing the barriers and attitudes perceived by patients with ovarian cancer who did not receive their primary surgery from a gynecologic oncologist and by diagnosing providers in an exploratory qualitative study. Materials and Methods: Patients and providers were sampled through the Iowa Cancer Registry. Participants were interviewed by telephone about barriers that patients face receiving surgical care from a specialist. Interviews were transcribed verbatim, and thematic analysis was completed by two team members. Findings: Providers ( n = 10, 13% participation rate) identified many system-level barriers, including poor provider-to-provider communication, long time-to-surgery wait times, and a limited number of gynecologic oncologists working in their referral range. Patients ( n = 16, 38% participation rate) denied system-level barriers; however, no patients reported receiving a referral to a gynecologic oncologist. This, in and of itself, constitutes a system-level barrier. Providers identified many barriers that their patients face, whereas patients failed to identify these barriers and denied facing them. Patients described the shock that they experienced after diagnosis and its limitations on their decision-making process. Both providers and patients agreed that the providers were influential in determining care decisions. Discussion: There is a divergence in the perceptions of barriers to care between providers and patients. Open discussions are needed about options and clinical guidelines for surgical ovarian cancer care. Further research is needed to develop and evaluate mechanisms to improve provider-to-patient discussions about surgical recommendations.

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Section: Introductionmentioning

confidence: 99%

Patient and Provider Perspectives on Barriers to Accessing Gynecologic Oncologists for Ovarian Cancer Surgical Care

Weeks

West

Lynch

et al. 2020

Women's Health Reports

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“…Similarly, Thiels et al and Visser et al found 30.1% of patients with gastric cancer and 34.5% of patients with pancreatic cancer, respectively, received guideline-adherent care [30,31]. Rates of compliance have ranged from as low as around 30% to higher rates of compliance from nearly 60-80% compliance, depending on cancer type and region of practice [16,23,32,33]. One potential explanation for the high proportion of NCCN AdC observed in our study compared with reports in other cancers is that, in general, there is greater consensus on the guidelines for the treatment of ASCC, supported by clinical trial-based research.…”

Section: Discussionmentioning

confidence: 97%

Population-Based Analysis of National Comprehensive Cancer Network (NCCN) Guideline Adherence for Patients with Anal Squamous Cell Carcinoma in California

Kumar

Rosario

Chang

et al. 2023

Cancers

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Purpose: We analyzed adherence to the National Comprehensive Cancer Network treatment guidelines for anal squamous cell carcinoma in California and the associated impacts on survival. Methods: This was a retrospective study of patients in the California Cancer Registry aged 18 to 79 years with recent diagnoses of anal squamous cell carcinoma. Predefined criteria were used to determine adherence. Adjusted odds ratios and 95% confidence intervals were estimated for those receiving adherent care. Disease-specific survival (DSS) and overall survival (OS) were examined with a Cox proportional hazards model. Results: 4740 patients were analyzed. Female sex was positively associated with adherent care. Medicaid status and low socioeconomic status were negatively associated with adherent care. Non-adherent care was associated with worse OS (Adjusted HR 1.87, 95% CI = 1.66, 2.12, p < 0.0001). DSS was worse in patients receiving non-adherent care (Adjusted HR 1.96, 95% CI = 1.56, 2.46, p < 0.0001). Female sex was associated with improved DSS and OS. Black race, Medicare/Medicaid, and low socioeconomic status were associated with worse OS. Conclusions: Male patients, those with Medicaid insurance, or those with low socioeconomic status are less likely to receive adherent care. Adherent care was associated with improved DSS and OS in anal carcinoma patients.

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Short-term survival analysis of a risk-adjusted model for ovarian cancer care

Hari,

Chang,

Villanueva

et al. 2024

Gynecologic Oncology

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Population-Based Analysis of Patient Age and Other Disparities in the Treatment of Ovarian Cancer in Central Appalachia and Kentucky

Cited by 5 publications

References 24 publications

Patient and Provider Perspectives on Barriers to Accessing Gynecologic Oncologists for Ovarian Cancer Surgical Care

Patient and Provider Perspectives on Barriers to Accessing Gynecologic Oncologists for Ovarian Cancer Surgical Care

Population-Based Analysis of National Comprehensive Cancer Network (NCCN) Guideline Adherence for Patients with Anal Squamous Cell Carcinoma in California

Short-term survival analysis of a risk-adjusted model for ovarian cancer care

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