Tomi Akinyemiju, PhD, social and molecular cancer epidemiologist and associate director, Community Outreach, Engagement and Equity (COEE) at DCI, and Rebecca Previs, MD, adjunct gynecologic oncology faculty.
Study Finds Patient’s Race Affects Ovarian Cancer Care
Non-Hispanic Black patients are less likely to receive guideline-appropriate treatment for ovarian cancer than non-Hispanic White patients, significantly affecting their treatment quality and survival chances.
The researchers focused on whether there were any racial differences in the application of guidelines among women with ovarian cancer. The guidelines specify treatment standards such as performing surgeries to assess cancer stage or administering the appropriate number of chemotherapy cycles.
More than 6,600 Medicare patients with ovarian cancer were analyzed from a database. Of those, 23.8% of White patients received guideline-appropriate surgery and chemotherapy compared to 14.2% of Black patients.
Chief of the Division of Gynecologic Oncology in the Duke Department of Obstetrics and Gynecology Andrew Berchuck, MD, and Chief Resident Mary Katherine Montes De Oca in the OR.
The racial disparities in treatment persisted even after accounting for patients’ ability to pay, the distance they drove to receive care, and the availability of specialists or cancer centers in their area.
“While fewerthan a third of all patients received quality ovarian cancer treatment, the racial disparity is striking and extremely concerning,”Akinyemiju said.She cited the legacy of structural racism – notably the lack of access to jobs that include high-quality healthcare benefits and housing patterns with limited access to healthcare resources in predominantly Black neighborhoods.
The researchers said the study reinforces earlier findings that ovarian cancer patients have worse outcomes when they do not receive guideline-based treatment.
“It is important to ensure that oncologists are approaching each patient without bias,” Montes De Oca said. “Guidelines provide a standard by which all providers should care for patients with cancer, regardless of region and regardless of patient race and/or ethnicity. Additional funding, training, and resources are required in underserved areas to ensure that these guidelines are put into practice.”
This spring, the "Andrew Berchuck, MD, Gynecologic Oncology Endowed Lectureship" was established in celebration of Dr. Berchuck's "remarkable legacy to the subspecialty of gynecologic oncology and to training the next generation of physicians dedicated to research, education, and patient care."
Andrew Berchuck, MD, the James M. Ingram Distinguished Professor of Gynecologic Oncology, is the third and current chief of the Division of Gynecologic Oncology (2005 to present) in the Duke Department of Obstetrics and Gynecology. An accomplished gynecologic oncologist and researcher, he also directs the Duke Cancer Institute Gynecologic Cancer Disease Group, and is co-director, with Jennifer Plichta, MD, MS, of Cancer Genetics at DCI.
Berchuck joined the Duke Comprehensive Cancer Center (now DCI) in 1987. Since day one he’s led a research program focused on the molecular-genetic alterations involved in the malignant transformation of the ovarian and endometrial epithelium. He maintains a clinical practice in surgical and medication management of individuals with ovarian, endometrial, and lower genital tract cancers.
Along the way, he's had the privilege to train about 40 fellows and some 250 residents. And while Berchuck has been at Duke long enough to witness some medical students become residents, then fellows, and eventually partners, the focus of the endowment, he said, is to re-establish and maintain connections with former Division fellows who are no longer at Duke and bring them back to learn about their work and how the training they received at Duke has served them in their careers through the annual oncology lectureship and possibly other events.
It was in that vein that the Division's second chief Daniel Clarke-Pearson, MD, a Duke resident and fellow in the 1970s who went on to lead the Division of Gynecologic Oncology from 1987 to 2005 — was invited to deliver the inaugural "Andrew Berchuck, MD, Gynecologic Oncology Endowed Lecture" on May 31.
Said Ob/Gyn Department Chair Matthew Barber, MD, before introducing the speaker that morning, "As I was thinking about this endowment and Andy, the one word that kept coming to mind was impact. And he has had just an incredible impact on this institution, on the Division of Gynecologic Oncology, on the Duke Cancer Institute, on the field of gynecologic oncology, and on the thousands of patients that he's had the opportunity to care for, as well as (his impact on) many medical students, residents, and fellows, and he's done it in so many ways — as a compassionate caregiver, as an extremely skilled surgeon, as an innovator, as a scientist, as a mentor, as a teacher, as a leader. And, in fact, I would say that Dr. Berchuck really is the archetype of the Triple Threat."
Last month, three Duke Cancer Institute facultyin the Department of OB-GYN, Division of Gynecologic Oncology —Brittany Davidson, MD;Haley Moss, MD, MBA; andAngeles Alvarez Secord, MD, MSc—andaDCI faculty member in the Department of Medicine, Division ofPopulation Health Sciences (Arif Kamal, MD, MBA, MHS)participated in national-level events under the auspices of theWhite House Cancer Moonshot Initiative.
First launched in 2016 by the Obama administration and led by then-Vice President Joe Biden to“accelerate scientific discovery in cancer, foster greater collaboration, and improve the sharing of cancer data,” theCancer Moonshotwas reignited in February 2022 byPresident Joe Biden and First Lady Jill Biden,Ed.D.The new goals are to “reduce the cancer death rate by half within 25 years and to improve the lives of people with cancer and cancer survivors.”(The Cancer Moonshot was not active during the Trump administration.)
In October, the focus was on breast and gynecologic cancers.
