Objective-To investigate disparities in the frequency of ovarian cancer-related surgical procedures and access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer according to race.
Methods-TheCalifornia Office of Statewide Health Planning and Development database was accessed for women undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 1/1/06 and 12/31/10. Multivariate logistic regression analyses were used to evaluate differences in the odds of selected surgical procedures and access to high-volume centers (hospitals≥20 cases/year) according to racial classification.Results-A total of 7,933 patients were identified: White=5,095 (64.2%), Black=290 (3.7%), Hispanic/Latino=1,400 (17.7%), Asian/Pacific Islander=836 (10.5%) and other=312 (3.9%). White patients served as reference for all comparisons. All minority groups were significantly younger (Black mean age 57.7 years, Hispanic 53.2 years, Asian 54.5 years vs. 61.1 years, p <0.01). Hispanic patients had lower odds of obtaining care at a high-volume center (adjusted OR (adj. OR)=0.72, 95% CI=0.64-0.82, p<0.01) and a lower likelihood of lymphadenectomy (adj. OR=0.80, 95%CI=0.70-0.91, p<0.01), bowel resection (adj. OR=0.80, 95% CI=0.71-0.91, p<0.01), and peritoneal biopsy/omentectomy (adj. OR=0.69, 95% CI=0.58-0.82, p<0.01). Black racial classification was associated with a lower likelihood of lymphadenectomy (adj. OR=0.76, p=0.03).Conclusions-Among women undergoing initial surgery for ovarian cancer, Hispanic patients are significantly less likely to be operated on at a high-volume center, and both Black and Hispanic patients are significantly less likely to undergo important ovarian cancer-specific surgical procedures compared to White patients.