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Racial and ethnic disparities over time in the treatment and mortality of women with gynecological malignancies.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2018 Apr; Vol. 149 (1), pp. 4-11. - Publication Year :
- 2018
-
Abstract
- Objective: To examine temporal trends in treatment and survival among black, Asian, Hispanic, and white women diagnosed with endometrial, ovarian, cervical, and vulvar cancer.<br />Methods: Using the National Cancer Database (2004-2014), we identified women diagnosed with endometrial, ovarian, cervical, and vulvar cancer. For each disease site, we analyzed race/ethnicity-specific trends in receipt of evidence-based practices. Professional societies' recommendations were used to define these practices. Using data from the Surveillance, Epidemiology, and End Results Program (2000-2009) we analyzed trends in 5-year survival.<br />Results: Throughout the study period black (64.8%) and Hispanic (68.3%) women were less likely to undergo lymphadenectomy for stage I ovarian cancer compared to Asian (79.5%) and white patients (74.6%). Black women were the least likely group to undergo lymphadenectomy in all periods. Among patients with stage II-IV ovarian cancer, 76.6% of white and Asian women received both surgery and chemotherapy, compared to 70.8% of black and 73.9% Hispanic women. Hispanic women with deeply invasive or high-grade stage I endometrial cancer underwent lymphadenectomy less frequently (74.5%) than all other groups (80.7%). Black women were less likely to have chemo-radiotherapy for stage IIB-IVA cervical cancer (75.6% versus 80.4% of all others). Black women were also less likely to have a surgical lymph node evaluation for vulvar cancer (58.8% versus 63.5% of all others). Among women diagnosed with ovarian, endometrial, and cervical cancer, black women had lower five-year survival than other groups.<br />Conclusion: Significant racial disparities persist in the delivery of evidence-based care. Black women with ovarian, endometrial, and cervical cancer continue to experience higher cancer-specific mortality than other groups.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Genital Neoplasms, Female ethnology
Humans
Kaplan-Meier Estimate
Lymph Node Excision statistics & numerical data
Medical Oncology methods
Medical Oncology statistics & numerical data
Middle Aged
SEER Program
United States epidemiology
Black or African American statistics & numerical data
Asian statistics & numerical data
Genital Neoplasms, Female mortality
Genital Neoplasms, Female therapy
Healthcare Disparities ethnology
Hispanic or Latino statistics & numerical data
White People statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 149
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 29605048
- Full Text :
- https://doi.org/10.1016/j.ygyno.2017.12.006