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Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis.

Publication ,  Journal Article
Karanth, S; Fowler, ME; Mao, X; Wilson, LE; Huang, B; Pisu, M; Potosky, A; Tucker, T; Akinyemiju, T
Published in: JNCI Cancer Spectr
December 2019

BACKGROUND: Ovarian cancer remains a leading cause of death from gynecological malignancies. Race, socioeconomic status (SES), and access to health care are important predictors of quality treatment and survival. We provide a systematic review and meta-analysis on the role of these predictors on disparities in ovarian cancer treatment and mortality. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, EMBASE, and Scopus for relevant articles published between January 2000 and March 2017. We selected studies published in the United States that evaluated the role of race, SES, or health-care access on disparities in ovarian cancer treatment or survival. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated for each outcome using a random-effects model. RESULTS: A total of 41 studies met the inclusion criteria for systematic review. In meta-analysis, there was a 25% decrease (RR = 0.75, 95% CI = 0.66 to 0.84) in receipt of adherent ovarian cancer treatment and 18% increased risk (RR = 1.18, 95% CI = 1.11 to 1.26) of mortality for blacks compared to whites. Receipt of adherent ovarian cancer treatment was 15% lower (RR = 0.85, 95% CI = 0.77 to 0.94) in the lowest vs highest SES group and 30% lower (RR = 0.70, 95% CI = 0.58 to 0.85) among patients at lower vs higher hospital volumes. CONCLUSION: We found consistent and strong evidence for continued lack of quality ovarian cancer treatment and higher mortality among ovarian cancer patients who are black, are of low SES, and/or have poor access to care. Interventions focused on these groups targeting specific barriers to care are needed to reduce disparities in ovarian cancer treatment and mortality.

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Published In

JNCI Cancer Spectr

DOI

EISSN

2515-5091

Publication Date

December 2019

Volume

3

Issue

4

Start / End Page

pkz084

Location

England

Related Subject Headings

  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
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Karanth, S., Fowler, M. E., Mao, X., Wilson, L. E., Huang, B., Pisu, M., … Akinyemiju, T. (2019). Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis. JNCI Cancer Spectr, 3(4), pkz084. https://doi.org/10.1093/jncics/pkz084
Karanth, Shama, Mackenzie E. Fowler, XiHua Mao, Lauren E. Wilson, Bin Huang, Maria Pisu, Arnold Potosky, Tom Tucker, and Tomi Akinyemiju. “Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis.JNCI Cancer Spectr 3, no. 4 (December 2019): pkz084. https://doi.org/10.1093/jncics/pkz084.
Karanth S, Fowler ME, Mao X, Wilson LE, Huang B, Pisu M, et al. Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis. JNCI Cancer Spectr. 2019 Dec;3(4):pkz084.
Karanth, Shama, et al. “Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis.JNCI Cancer Spectr, vol. 3, no. 4, Dec. 2019, p. pkz084. Pubmed, doi:10.1093/jncics/pkz084.
Karanth S, Fowler ME, Mao X, Wilson LE, Huang B, Pisu M, Potosky A, Tucker T, Akinyemiju T. Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis. JNCI Cancer Spectr. 2019 Dec;3(4):pkz084.

Published In

JNCI Cancer Spectr

DOI

EISSN

2515-5091

Publication Date

December 2019

Volume

3

Issue

4

Start / End Page

pkz084

Location

England

Related Subject Headings

  • 3211 Oncology and carcinogenesis