HONOLULU, HI – In the general population, mortality rates from epithelial ovarian cancer show stark differences by race and ethnicity.
In fact, non-Hispanic Black (NHB) women die at higher rates, despite age, from EOC than Non-Hispanic White (NHW) women, Pacific Islander (PI) and Non-Hispanic Black (NHB) women. Asian Americans (AS), meanwhile, have even lower mortality, according to a study at the 2021 American Society of Clinical Oncology (ASCO) annual meeting.1
“It is unknown whether these patterns reflect biological differences, environmental exposure or perhaps access to care. Our objective was to investigate whether self-reported race/ethnicity is associated with differences in EOC survival in a military population where patients have equal access to healthcare,” noted the authors from Tripler Army Medical Center in Honolulu and colleagues.
To find out, they looked at a study population of 1,151 women diagnosed with EOC — ovarian, fallopian tube and primary peritoneal cancers — among DoD beneficiaries reported in the Automated Central Tumor Registry Database, with the year of diagnosis ranging from 2001-18. Of the patients, 796 were NHW, 111 were NHB, 130 were AS, 49 were PI and 65 were Hispanic (HS). All EOC patients had complete information on age at diagnosis, stage and chemotherapy treatment, the authors added.
Researchers reported that, during a median follow-up of 3.5 years (1.8-6.7), 702 EOC patients (61%) died of all causes.
Results indicated that, when comparing crude EOC patient characteristics by racial/ethnic group, NHW had the highest frequency of EOC leading to death — 58% vs. less than 49% in other groups. The study team also identified differences in histology; For example, NHW and NHB had a higher frequency of serous tumors, more than 56% of EOCs vs. less than 52% in other groups. At the same time, Pacific-Islanders had a high proportion of endometrioid histology (14% of EOCs vs. < 11% in others), and 10% of EOCs among Asian-Americans had clear cell histology (vs. < 9% in others).In addition, Hispanic women were observed to have a high percentage of local disease (23% vs. < 20% in others).
Taking that all into account, the study team identified no disparities in military care, explaining, “In multivariable survival analysis adjusting for clinical factors, we observed that compared with NHW, there were no differences in EOC survival by race/ethnicity: AS, HR = 0.80 (95% CI = 0.61-1.05); NHB, HR = 0.96 (95% CI = 0.72-1.28); PI, HR = 0.92 (95% CI = 0.58-1.46); and HS, HR = 0.82 (95% CI = 0.56-1.21).”
“These results highlight the importance of studying how differences in access to healthcare may impact observed racial/ethnic disparities for EOC,” the authors concluded.
- Arter LA, Desmond D, Berenberg JL, Merritt MA. (June 4-8, 2021) Epithelial ovarian cancer survival by race/ethnicity in an equal-access healthcare population. ASCO 2021 annual meeting. Virtual. https://meetinglibrary.asco.org/record/199570/abstract