Study Finds Patient’s Race Affects Ovarian Cancer Care

doctor seeing a patient in clinic
Tomi Akinyemiju and Rebecca Previs
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.

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 study, appearing online in the Journal of the National Comprehensive Cancer Network, was led by Duke Health researchers Mary Katherine Montes De Oca, MD, a resident in Duke’s Department of Obstetrics and Gynecology, and Tomi Akinyemiju, PhD, associate professor in the Department of Population Health Sciences.

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.

Andrew Berchuck Chief Resident Mary Katherine Montes De Oca in the OR
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 fewer than 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.”


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