Differences in overall survival for invasive epithelial ovarian cancer by race and ethnicity: results from the Ovarian Cancer Association Consortium — The Association Specialists
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Differences in overall survival for invasive epithelial ovarian cancer by race and ethnicity: results from the Ovarian Cancer Association Consortium (23912)

Nicola S Meagher 1 , Kami K White 2 , Lynne R Wilkens 2 , Melissa A Merritt 3
  1. University of New South Wales, Sydney, NSW, Australia
  2. University of Hawaii Cancer Center, Honolulu, HI, USA
  3. The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia

Background: Prior studies have examined survival in patients with epithelial ovarian cancer (EOC); however, few reports considered race and ethnicity, particularly disaggregating Asian and Native Hawaiian/Pacific Islander women.

 

Methods: We analysed pooled individual data from patients with EOC in 18 Ovarian Cancer Association Consortium studies based in Australia, Belgium, Canada, England and the USA including subjects from Asian (n=697), non-Hispanic Black (n=267), Hispanic (n=492), Native Hawaiian/Pacific Islander (n=98) and non-Hispanic White (n=12,998) racial and ethnic groups. Cox proportional hazards models were used to estimate Hazard Ratios and 95% confidence intervals (HR, 95% CI) for overall survival (all-cause death) by race and ethnicity, adjusting for age, year of diagnosis and histotype and including strata variables for study and stage. Fully adjusted models accounted for BMI, smoking and postmenopausal hormone use. We also examined associations between hormone-related factors and family history and overall survival by race and ethnicity, testing for heterogeneity.

 

Results: Compared to non-Hispanic White patients with EOC, Native Hawaiian/Pacific Islander and non-Hispanic Black women had poorer survival (HR=1.58, 95% CI=1.16-2.14, and HR=1.31, 95% CI=1.12-1.54 respectively for death). In analyses of the most common histotype of EOC (serous), the association was more pronounced for Native Hawaiian/Pacific Islander patients (HR=2.00, 95% CI=1.37-2.92). There was no significant heterogeneity in the associations between epidemiological factors and survival by racial and ethnic groups (p≥0.31).

 

Conclusion: To our knowledge this was the first consortium study to disaggregate Native Hawaiian and Pacific Islander women from Asian women to study EOC survival while accounting for factors (postmenopausal hormone use, BMI, and smoking) previously shown to influence survival. Native Hawaiian/Pacific Islander and non-Hispanic Black patients with EOC had poorer survival outcomes, highlighting the need to conduct further research to identify the social, economic, or healthcare access issues that may drive this inequity with a focus on finding solutions.