Purpose

The purpose of this study was to assess the association between race/ethnicity and all-cause mortality among women with advanced-stage ovarian cancer who received systemic therapy.

Methods

We analyzed data from the National Cancer Database on women diagnosed with advanced-stage ovarian cancer from 2004 to 2015 who received systemic therapy. Race/ethnicity was categorized as Non-Hispanic (NH) White, NH-Black, Hispanic, NH-Asian/Pacific Islander, and Other. Income and education were combined to form a composite measure of socioeconomic status (SES) and categorized into low-, mid-, and high-SES. Multivariable Cox proportional hazards models were used to assess whether race/ethnicity was associated with the risk of death after adjusting for sociodemographic, clinical, and treatment factors. Additionally, subgroup analyses were conducted by SES, age, and surgery receipt.

Results

The study population comprised 53,367 women (52.4% ages ≥ 65 years, 82% NH-White, 8.7% NH-Black, 5.7% Hispanic, and 2.7% NH-Asian/Pacific Islander) in the analysis. After adjusting for covariates, the NH-Black race was associated with a higher risk of death versus NH-White race (aHR: 1.12; 95% CI: 1.07,1.18), while Hispanic ethnicity was associated with a lower risk of death compared to NH-White women (aHR: 0.87; 95% CI: 0.80, 0.95). Furthermore, NH-Black women versus NH-White women had an increased risk of mortality among those with low-SES characteristics (aHR:1.12; 95% CI:1.03–1.22) and mid-SES groups (aHR: 1.13; 95% CI:1.05–1.21).

Conclusions

Among women with advanced-stage ovarian cancer who received systemic therapy, NH-Black women experienced poorer survival compared to NH-White women. Future studies should be directed to identify drivers of ovarian cancer disparities, particularly racial differences in treatment response and surveillance.

中文翻译：

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接受全身治疗的晚期卵巢癌女性生存率的种族和社会经济差异

目的

本研究的目的是评估接受全身治疗的晚期卵巢癌女性的种族/族裔与全因死亡率之间的关联。

方法

我们分析了国家癌症数据库中 2004 年至 2015 年诊断为晚期卵巢癌并接受全身治疗的女性的数据。种族/族裔被分类为非西班牙裔 (NH) 白人、NH-黑人、西班牙裔、NH-亚裔/太平洋岛民和其他。收入和教育结合起来形成社会经济地位（SES）的综合衡量标准，并分为低、中和高 SES。在调整社会人口统计学、临床和治疗因素后，使用多变量 Cox 比例风险模型来评估种族/民族是否与死亡风险相关。此外，还根据 SES、年龄和手术收据进行了亚组分析。

结果

分析中的研究人群包括 53,367 名女性（52.4% 年龄≥ 65 岁，82% NH-白人，8.7% NH-黑人，5.7% 西班牙裔，2.7% NH-亚裔/太平洋岛民）。调整协变量后，与 NH 白人种族相比，NH 黑人种族与更高的死亡风险相关（aHR：1.12；95% CI：1.07,1.18），而与 NH 白人种族相比，西班牙裔种族与较低的死亡风险相关NH-白人女性（aHR：0.87；95% CI：0.80，0.95）。此外，在低 SES 特征组（aHR：1.12；95% CI：1.03–1.22）和中 SES 组（aHR：1.13；95% CI）中，NH 黑人女性与 NH 白人女性相比，死亡风险更高：1.05–1.21）。

结论

在接受全身治疗的晚期卵巢癌女性中，与 NH 白人女性相比，NH 黑人女性的生存率较差。未来的研究应旨在确定卵巢癌差异的驱动因素，特别是治疗反应和监测方面的种族差异。