Socioeconomic and Access Disparities in Ovarian Cancer Treatment and Outcomes: A Retrospective Cohort Study

Document Type

Conference Proceeding

Publication Date

5-27-2026

Publication Title

J Clin Oncol

Keywords

adult, advanced cancer, aged, all cause mortality, Black person, cancer mortality, cancer registry, cancer staging, cancer therapy, Caucasian, cohort analysis, conference abstract, controlled study, data extraction, disease assessment, female, groups by age, health disparity, human, International Diabetes Federation, major clinical study, male, multimodality cancer therapy, ovary cancer, progression free survival, recurrence risk, recurrent disease, retrospective study, risk factor, socioeconomics, surgery, systemic therapy, very elderly

Abstract

Background: Ovarian cancer ranks eighth in common causes of cancer/cancer-related death worldwide. Its high mortality can be attributed to 70% of cases being diagnosed at advanced stage disease, leading to a high relapse rate despite multimodal therapy, such as chemotherapy, surgery, and newer targeted immunotherapy. Despite efforts to improve screening among women for health disparities, barriers to healthcare often remain multifaceted and difficult to identify. There are gaps in the literature regarding how variables such as insurance type and distance relative to the treatment facility affect disease outcomes. This study aims to identify key socioeconomic factors (SES) and health disparities, and to assess whether these variables influence receipt of any treatment within one month of initial diagnosis and progression-free survival (PFS). Methods: This single-system retrospective cohort study analyzed 555 adult patients with ovarian cancer cases diagnosed between January 1, 2016, and February 28, 2025, as identified in the Henry Ford Health cancer registry. PFS was defined as the time from systemic therapy initiation to the first documented disease progression (recurrence) or death from any cause, with patients without an event censored at the earlier of the last disease assessment or the data extraction date (Dec 10, 2025). A multivariable logistic regression model and a Cox proportional hazards model were used to assess the associations between SES and (1) receiving treatment within one month and (2) PFS, respectively. Results: Older age groups had lower odds of receiving treatment within one month compared with patients younger than 50 years. Patients living 25–50 miles from their initial diagnosis facility had 20.9% higher odds of receiving treatment within one month compared to those within 25 miles. Stage II and III patients had 19.1% and 23.5% lower odds of receiving treatment within one month, respectively, than stage I patients. Patients aged 50-59 had nearly a 3-fold higher hazard ratio (HR) of death or disease progression (DDP) compared to 18-49, while 60-69 had a 2.2-fold higher HR. Patients aged 70-79 had a 4.2-fold higher HR; those aged 80+ had a 4.7-fold higher HR. Compared to White patients, Black patients had a 1.7-fold higher HR of DDP. Patients with dual eligible payer had a 2.4-fold higher HR of DDP compared to private payers. Patients who lived 25–50 miles from their initial diagnosis facility (IDF) had 72.1% higher HR of DDP compared to those within 25 miles, and those who lived 50+ miles from their IDF had more than 3-fold higher HR. Conclusions: Older age groups and patients with more advanced cancer stages had significantly lower odds of receiving any treatment within one month. Among patients undergoing systemic therapy, older age, black race, higher cancer stage, dual eligible payer status, and living farther from the diagnosis facility were significant risk factors for DDP.

Volume

44

Issue

16

First Page

e17569

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