Older black women do not receive chemotherapy as often as white women after ovarian cancer surgery
Clinical guidelines have recommended since 1994 that all women diagnosed with ovarian cancer at stage IC-IV or higher receive chemotherapy following surgery to remove the cancer. However, a new study by University of Texas researchers finds that older black women with stage IC-IV or more advanced ovarian cancer are not as likely as older white women to receive both surgery and chemotherapy. Yet, both groups of women die at the same rates of this deadly cancer.
For ovarian cancer, a stage IC classification means the cancer is contained to one or both ovaries but is showing early signs of spreading. The higher the classification (e.g., stage III or IV), the more advanced the disease is. Ovarian cancer is commonly diagnosed at a more advanced stage because no screening test for it exists.
The researchers linked 11 years of Surveillance, Epidemiology and End Results data with Medicare data for 4,264 white and black women age 65 or older who were diagnosed with stage IC-IV ovarian cancer. Just over 50 percent of the black women received chemotherapy after surgery compared with nearly 65 percent of the white women. The survival rates did not differ between the two groups of women.
The women's socioeconomic status (SES) affected their access to both surgery and chemotherapy. Women with higher SES had increased use of both surgery and chemotherapy compared with women with lower SES. The authors state that about 35 percent of women are missing out on improved chances of surviving ovarian cancer because they are not receiving the combined benefit of surgery and chemotherapy. Women with the lowest quartile of SES were more likely to die than those with the highest quartile of SES. The authors recommend that all eligible patients receive both surgery and chemotherapy, regardless of their race, SES, or age. This study was funded in part by the Agency for Healthcare Research and Quality (HS16743).
See "Ethnic differences in socioeconomic status, diagnosis, treatment, and survival among older women with epithelial ovarian cancer," by Xianglin L. Du, M.D., Ph.D., Charlotte C. Sun, Dr.P.H., M.P.H., Michael R. Milam, M.D., M.P.H, and others in the July/August 2008 International Journal of Gynecologic Cancer 18(4), pp. 660-669.
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