(HealthDay News) — Health care access (HCA) dimensions are associated with receipt of guideline-concordant therapy, but they do not fully explain racial disparities among patients with ovarian cancer, according to a study published in the November issue of the Journal of the National Comprehensive Cancer Network.
Mary Katherine Montes de Oca, M.D., from the Duke University School of Medicine in Durham, North Carolina, and colleagues examined how various dimensions of HCA contribute to racial disparities using data from non-Hispanic (NH)-Black, Hispanic, and NH-White patients with ovarian cancer diagnosed in 2008 to 2015. HCA dimensions were defined as affordability, availability, and accessibility, measured as aggregate scores. A total of 5,632 patients were included in the study cohort: 6, 6, and 88 percent were NH-Black, Hispanic, and NH-White, respectively.
The researchers found that only 23.8 and 14.2 percent of NH-White and NH-Black patients received guideline-concordant surgery and the full cycles of chemotherapy. Receipt of guideline-concordant surgery was seen in association with higher affordability and availability (relative risks, 1.05 and 1.06, respectively), while higher affordability was also associated with initiation of systemic therapy (hazard ratio, 1.09). NH-Black patients remained less likely than NH-White patients to initiate systemic therapy after adjustment for all three HCA scores and demographic and clinical characteristics (hazard ratio, 0.86).
“Further research on other HCA dimensions and a thorough examination of facilitators and barriers to treatment are needed to enhance delivery of optimal treatment and close the racial gap in survival for patients with ovarian cancer,” the authors write.
Two authors disclosed financial ties to the biopharmaceutical industry.