Racial disparities and patterns of ovarian cancer surgical care in California

F. W. Liu, L. M. Randall, K. S. Tewari, R. E. Bristow

Research output: Contribution to journalArticle

Abstract

Objective To investigate disparities in the frequency of ovarian cancer-related surgical procedures and access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer according to race. Methods The California Office of Statewide Health Planning and Development database was accessed for women undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 1/1/06 and 12/31/10. Multivariate logistic regression analyses were used to evaluate differences in the odds of selected surgical procedures and access to high-volume centers (hospitals ≥ 20 cases/year) according to racial classification. Results A total of 7933 patients were identified: White = 5095 (64.2%), Black = 290 (3.7%), Hispanic/Latino =1400 (17.7%), Asian/Pacific Islander = 836 (10.5%) and other = 312 (3.9%). White patients served as reference for all comparisons. All minority groups were significantly younger (Black mean age 57.7 years, Hispanic 53.2 years, Asian 54.5 years vs. 61.1 years, p <0.01). Hispanic patients had lower odds of obtaining care at a high-volume center (adjusted OR (adj. OR) = 0.72, 95% CI = 0.64-0.82, p <0.01) and a lower likelihood of lymphadenectomy (adj. OR = 0.80, 95% CI = 0.70-0.91, p <0.01), bowel resection (adj. OR = 0.80, 95% CI = 0.71-0.91, p <0.01), and peritoneal biopsy/omentectomy (adj. OR = 0.69, 95% CI = 0.58-0.82, p <0.01). Black racial classification was associated with a lower likelihood of lymphadenectomy (adj. OR = 0.76, 95% CI = 0.59-0.97, p = 0.03). Conclusions Among women undergoing initial surgery for ovarian cancer, Hispanic patients are significantly less likely to be operated on at a high-volume center, and both Black and Hispanic patients are significantly less likely to undergo important ovarian cancer-specific surgical procedures compared to White patients.

Original languageEnglish (US)
Pages (from-to)221-226
Number of pages6
JournalGynecologic Oncology
Volume132
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

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Hispanic Americans
Ovarian Neoplasms
Lymph Node Excision
High-Volume Hospitals
Minority Groups
Health Planning
Ovariectomy
Logistic Models
Regression Analysis
Databases
Biopsy

Keywords

  • Ovarian cancer
  • Racial disparities

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Racial disparities and patterns of ovarian cancer surgical care in California. / Liu, F. W.; Randall, L. M.; Tewari, K. S.; Bristow, R. E.

In: Gynecologic Oncology, Vol. 132, No. 1, 01.2014, p. 221-226.

Research output: Contribution to journalArticle

Liu, F. W. ; Randall, L. M. ; Tewari, K. S. ; Bristow, R. E. / Racial disparities and patterns of ovarian cancer surgical care in California. In: Gynecologic Oncology. 2014 ; Vol. 132, No. 1. pp. 221-226.
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abstract = "Objective To investigate disparities in the frequency of ovarian cancer-related surgical procedures and access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer according to race. Methods The California Office of Statewide Health Planning and Development database was accessed for women undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 1/1/06 and 12/31/10. Multivariate logistic regression analyses were used to evaluate differences in the odds of selected surgical procedures and access to high-volume centers (hospitals ≥ 20 cases/year) according to racial classification. Results A total of 7933 patients were identified: White = 5095 (64.2{\%}), Black = 290 (3.7{\%}), Hispanic/Latino =1400 (17.7{\%}), Asian/Pacific Islander = 836 (10.5{\%}) and other = 312 (3.9{\%}). White patients served as reference for all comparisons. All minority groups were significantly younger (Black mean age 57.7 years, Hispanic 53.2 years, Asian 54.5 years vs. 61.1 years, p <0.01). Hispanic patients had lower odds of obtaining care at a high-volume center (adjusted OR (adj. OR) = 0.72, 95{\%} CI = 0.64-0.82, p <0.01) and a lower likelihood of lymphadenectomy (adj. OR = 0.80, 95{\%} CI = 0.70-0.91, p <0.01), bowel resection (adj. OR = 0.80, 95{\%} CI = 0.71-0.91, p <0.01), and peritoneal biopsy/omentectomy (adj. OR = 0.69, 95{\%} CI = 0.58-0.82, p <0.01). Black racial classification was associated with a lower likelihood of lymphadenectomy (adj. OR = 0.76, 95{\%} CI = 0.59-0.97, p = 0.03). Conclusions Among women undergoing initial surgery for ovarian cancer, Hispanic patients are significantly less likely to be operated on at a high-volume center, and both Black and Hispanic patients are significantly less likely to undergo important ovarian cancer-specific surgical procedures compared to White patients.",
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T1 - Racial disparities and patterns of ovarian cancer surgical care in California

AU - Liu, F. W.

AU - Randall, L. M.

AU - Tewari, K. S.

AU - Bristow, R. E.

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N2 - Objective To investigate disparities in the frequency of ovarian cancer-related surgical procedures and access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer according to race. Methods The California Office of Statewide Health Planning and Development database was accessed for women undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 1/1/06 and 12/31/10. Multivariate logistic regression analyses were used to evaluate differences in the odds of selected surgical procedures and access to high-volume centers (hospitals ≥ 20 cases/year) according to racial classification. Results A total of 7933 patients were identified: White = 5095 (64.2%), Black = 290 (3.7%), Hispanic/Latino =1400 (17.7%), Asian/Pacific Islander = 836 (10.5%) and other = 312 (3.9%). White patients served as reference for all comparisons. All minority groups were significantly younger (Black mean age 57.7 years, Hispanic 53.2 years, Asian 54.5 years vs. 61.1 years, p <0.01). Hispanic patients had lower odds of obtaining care at a high-volume center (adjusted OR (adj. OR) = 0.72, 95% CI = 0.64-0.82, p <0.01) and a lower likelihood of lymphadenectomy (adj. OR = 0.80, 95% CI = 0.70-0.91, p <0.01), bowel resection (adj. OR = 0.80, 95% CI = 0.71-0.91, p <0.01), and peritoneal biopsy/omentectomy (adj. OR = 0.69, 95% CI = 0.58-0.82, p <0.01). Black racial classification was associated with a lower likelihood of lymphadenectomy (adj. OR = 0.76, 95% CI = 0.59-0.97, p = 0.03). Conclusions Among women undergoing initial surgery for ovarian cancer, Hispanic patients are significantly less likely to be operated on at a high-volume center, and both Black and Hispanic patients are significantly less likely to undergo important ovarian cancer-specific surgical procedures compared to White patients.

AB - Objective To investigate disparities in the frequency of ovarian cancer-related surgical procedures and access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer according to race. Methods The California Office of Statewide Health Planning and Development database was accessed for women undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 1/1/06 and 12/31/10. Multivariate logistic regression analyses were used to evaluate differences in the odds of selected surgical procedures and access to high-volume centers (hospitals ≥ 20 cases/year) according to racial classification. Results A total of 7933 patients were identified: White = 5095 (64.2%), Black = 290 (3.7%), Hispanic/Latino =1400 (17.7%), Asian/Pacific Islander = 836 (10.5%) and other = 312 (3.9%). White patients served as reference for all comparisons. All minority groups were significantly younger (Black mean age 57.7 years, Hispanic 53.2 years, Asian 54.5 years vs. 61.1 years, p <0.01). Hispanic patients had lower odds of obtaining care at a high-volume center (adjusted OR (adj. OR) = 0.72, 95% CI = 0.64-0.82, p <0.01) and a lower likelihood of lymphadenectomy (adj. OR = 0.80, 95% CI = 0.70-0.91, p <0.01), bowel resection (adj. OR = 0.80, 95% CI = 0.71-0.91, p <0.01), and peritoneal biopsy/omentectomy (adj. OR = 0.69, 95% CI = 0.58-0.82, p <0.01). Black racial classification was associated with a lower likelihood of lymphadenectomy (adj. OR = 0.76, 95% CI = 0.59-0.97, p = 0.03). Conclusions Among women undergoing initial surgery for ovarian cancer, Hispanic patients are significantly less likely to be operated on at a high-volume center, and both Black and Hispanic patients are significantly less likely to undergo important ovarian cancer-specific surgical procedures compared to White patients.

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