By Alexis Porter, Duke Health News Office
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 Anastasio, MD, a resident in Duke Ob/Gyn, 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.
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,” Dr. Akinyemiju said. She cited the legacy of structural racism — notably the lack of access to jobs that include high-quality health care benefits and housing patterns with limited access to health care 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,” Dr. Anastasio 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.”