2015 APHA Annual Meeting & Expo

Home Events & Meetings Annual Meeting Schedule & Program

Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

333464
Effect of time on age-specific racial disparities and ovarian cancer survival among cases identified through the National Cancer Database (NCDB)


Tuesday, November 3, 2015 : 5:42 p.m. - 6:00 p.m.

Charlotte E. Joslin, OD, PhD, Dept. of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL
Anna B. Beckmeyer-Borowko, MBA, MPH, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, IL
Caryn E. Peterson, PhD, MS, Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL
Katherine C. Brewer, MPH, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, IL
Mary A. Otoo, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, IL
Kent Hoskins, MD, Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL
Faith G. Davis, PhD, School of Public Health University of Alberta, Edmonton, AB, Canada
Objective:  Previous research identified poorer survival among non-Hispanic blacks (NHB) than whites (NHW) diagnosed with invasive ovarian cancer (OVCA).  Treatment advances may have increased survival disparities as NHB are less likely to receive therapies consistent with National Comprehensive Cancer Network Guidelines, or even basic oncologic care.  The purpose is to characterize age-specific survival disparities in U.S. OVCA cases diagnosed from 1998-2006, and to determine the effect of time.

Methods:NHW and NHB cases from NCDB were analyzed to assess five-year survival.  Univariate analysis was used to compare race-stratified covariates with diagnosis year, analyzed in 2 periods (1998–2002 vs. 2003–2006).  Multivariable Cox proportional hazard regression models were fit to estimate the adjusted hazard ratio (HR) and 95% confidence interval (95% CI) between race and survival.  Tests for interaction between race and diagnosis period were performed in adjusted overall and age-specific models.

Results:  98,159 (92.6%) NHW and 8121 (7.4%) NHB were analyzed.  NHB had significantly poorer overall survival (HRadj=1.19, 95%CI=1.15-1.23), and interaction between race and diagnosis period was not significant (p = 0.51).  Age-specific models demonstrated poorer overall NHB survival varying by age (<50yrs, HRadj=1.16, 95%CI=1.06-1.26; 50-64yrs, HRadj=1.18, 95%CI=1.11-1.25; 65-74yrs, HRadj=1.28, 95%CI=1.20-1.37; 75+yrs, HRadj=1.11, 95%CI=1.04-1.18); interaction was significant only in women 50-64yrs, with disparities improving over time (50-64yrs:  1998-2002, HRadj=1.20, 95%CI=1.15-1.34; 2002-2006, HRadj=1.11, 95%CI=1.02-1.20; p = 0.04).

Conclusion:  Results identify NHB/NHW survival disparities that persist with some indication of improvement in certain ages.  Findings may underestimate disparities as NCDB reflects ~70% of US cases annually, generally including higher-tier, Commission on Cancer (CoC)-approved hospitals.

Learning Areas:

Biostatistics, economics
Epidemiology
Public health or related research

Learning Objectives:
Describe age-specific racial differences in ovarian cancer survival in U.S. women, using data from the National Cancer Database (NCDB), and the effect over time. Identify the effect of time on age-specific racial differences in ovarian cancer survival in two periods of diagnosis (1998 – 2002, 2003 – 2006)

Keyword(s): Cancer and Women’s Health, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on an American Cancer Society grant that investigates racial disparities in ovarian cancer outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4414.0: New Findings in Cancer Research and Epidemiology