Ovarian Cancer Disparities in Advanced Stage Diagnosis and Surgery Treatment: Multilevel Analysis of SEER 2001-2011 Data

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Introduction: Although racial/ethnic disparities in ovarian cancer have been documented, factors contributing to the disparities need further research. This study examines whether racial/ethnic disparity in ovarian cancer diagnosis and treatment can be explained by individual-level factors, contextual-level factors or both.

Methods: Surveillance, Epidemiology, and End Results (SEER) 13 data (2001-2011) were analyzed. Multilevel and multivariate logistic regression models were used to evaluate the disparities in ovarian cancer diagnosis and treatment adjusting for age, tumor pathological characteristics, marital status, insurance status, rural residency, county level socioeconomic characteristics, and year of diagnosis.

Result: 20,901 patient observations were analyzed. Compared to non-Hispanic white women, non-Hispanic black women were 1.22 (95% CI: 1.04-1.43) times more likely to have advanced stage diagnosis (p=0.015) and were 62% (95% CI: 0.31-0.47) less likely to receive surgery (p

Conclusion: While racial/ethnic disparity in ovarian cancer diagnosis and treatment is not driven by contextual-level factors examined in this study, observed geographic variation in surgery treatment warrants further attention in disparities research. Elucidating which individual- and contextual-level factors in addition to those examined in this study explain the geographic variation may inform intervention development to reduce ovarian cancer disparities.


American Public Health Association Annual Conference (APHA)


Chicago, IL