Inequality Among Women with Cancer

Ovarian cancer care and survival disparities

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Chief Medical Officer and Executive Vice President of the American Cancer Society, Otis Brawley, MD, is also the author of How We Do Harm - A Doctor Breaks Ranks About Being Sick in America.

Speaking to a conference of healthcare journalists*, Dr. Brawley said, "We leave a lot of people behind in our healthcare system."

This statement is especially true for women diagnosed with ovarian cancer. Poor and African American women have worse outcomes with the disease because they're less likely than white and affluent women to receive the best care. 

"Don't be afraid to ask for a second opinion."

Robert Bristow, MD, director of gynecologic oncology services at the University of California Irvine, presented the findings of a study involving 50,000 women at the 2012 Society of Gynecologic Oncology’s annual meeting.

“Not all women are benefiting equally from improvements in ovarian cancer care,” Dr. Bristow said. “The reasons behind these disparities are not entirely clear, which is why we need additional research.”

For the study, researchers wanted to learn about how race and socioeconomic status affected treatment for ovarian cancer.  They also wanted to see if care complied with National Comprehensive Cancer Network (NCCN) treatment guidelines.

To measure outcome, Dr. Bristow and his team looked at how many women were still alive five years after diagnosis (five-year survival rate). Here's what they found:

  • For care that met NCCN guidelines, 41.4 percent of white women and 33.3 percent of black women were alive after five years.
  • If the care didn't meet NCCN standards, the five-year survival rates were 37.8 percent for white women vs. 22.5 percent for black women.
  • Women who were on Medicaid had a 30 percent increased risk of death.
  • Worse survival rates were seen for poor women whose household incomes were less than $35,000 - regardless of their race.

Dr. Bristow believes that the effects of these disparities are likely the result of a combination of factors including race and income,  other medical conditions, culture and what he calls "social injustice." 

“Under the best circumstances, treating ovarian cancer is challenging, because there’s no screening tool available to detect the disease in its early stages,” Bristow said.

This study was part of a collaborative effort by the Society of Gynecologic Oncology, the Mayo Clinic and Washington University in St. Louis to assess and characterize the quality of ovarian cancer care in the United States.

Research is considered preliminary until it's published in a peer-reviewed journal.

No information was provided regarding funding or potential conflicts of interest.

*Dr. Brawley was the keynote speaker at the recent Health Journalism 2012 conference of the Association of Health Care Journalists, held April 16-22 in Atlanta.

Reviewed by: 
Review Date: 
May 8, 2012
Last Updated:
May 10, 2012