ArticleGynecologic oncology2014
Spatial analysis of adherence to treatment guidelines for advanced-stage ovarian cancer and the impact of race and socioeconomic status.
Article in Gynecologic oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 2 of them syntheses that pooled it.
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Who cites it
63 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- "When Offered to Participate": A Systematic Review and Meta-Analysis of Patient Agreement to Participate in Cancer Clinical Trials.Journal of the National Cancer Institute · 2021Pooled it
- Pooled it
- Residential Context and Survival Disparities in Black and White Women With Ovarian Cancer.JAMA network open · 2026Observational
- Lack of disparities in postoperative care after ileocecal resection in patients with Crohn's disease at tertiary inflammatory bowel diseases centers.Therapeutic advances in gastroenterology · 2026Article
- Influence of Pre-treatment CA 125 Levels on Survival Outcomes Across Ethnic Groups in Ovarian Cancer Patients.Journal of community hospital internal medicine perspectives · 2026Article
- Homologous Recombination Deficiency and Survival in Ovarian High-Grade Serous Carcinoma by Self-Reported Race.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Efficacy of pembrolizumab in combination with bevacizumab and oral metronomic cyclophosphamide in the treatment of platinum resistant recurrent ovarian cancer: a retrospective observational study.Gynecologic oncology reports · 2025Article
- All-cause mortality and neighborhood social vulnerability among women with ovarian cancer.Gynecologic oncology · 2025Article
- An Investigation of Travel Distance and Timeliness of Breast Cancer Treatment Among a Diverse Cohort in the United States.International journal of environmental research and public health · 2025Article
- Association of neighborhood social vulnerability with ovarian cancer survival.Gynecologic oncology · 2025Observational
- A latent class assessment of healthcare access factors and disparities in breast cancer care timeliness.PLoS medicine · 2024Article
- Short-term survival analysis of a risk-adjusted model for ovarian cancer care.Gynecologic oncology · 2024Article
- Mapping the spatial disparities of HIV prevalence in Ethiopian zones using the generalized additive model.Scientific reports · 2024Article
- Role of neighborhood context in ovarian cancer survival disparities: current research and future directions.American journal of obstetrics and gynecology · 2023Review
- Geographical Health District and Distance Traveled Influence on Clinical Status at Admission of Patients with Gestational Trophoblastic Disease.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2023Article
- Impact of socioeconomics and race on clinical follow-up and trial enrollment and adherence in cerebral cavernous malformation.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Article
- Article
- Health-care access dimensions and ovarian cancer survival: SEER-Medicare analysis of the ORCHiD study.JNCI cancer spectrum · 2023Article
- Race, Affordability and Utilization of Supportive Care in Ovarian Cancer Patients.Journal of pain and symptom management · 2022Article
- Drive Time and Receipt of Guideline-Recommended Screening, Diagnosis, and Treatment.JAMA network open · 2022Article
3 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo determine the impact of geographic location on advanced-stage ovarian cancer care adherence to the National Comprehensive Cancer Network (NCCN) guidelines in relation to race and socioeconomic status (SES).
methodsPatients diagnosed with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Generalized additive models were created to assess the effect of spatial distributions of geographic location, proximity to a high-volume hospital (≥20 cases/year), distance traveled to receive care, race, and SES on adherence to NCCN guidelines, with simultaneous smoothing of geographic location and adjustment for confounding variables. Disparities in geographic predictors of treatment adherence were analyzed with the x(2) test for equality of proportions.
resultsOf the 11,770 patients identified, 45.4% were treated according to NCCN guidelines. Black race (OR=1.49, 95%CI=1.21-1.83), low-SES (OR=1.46, 95%CI=1.24-1.72), and geographic location ≥80 km/50 mi from a high-volume hospital (OR=1.88, 95%CI=1.61-2.19) were independently associated with an increased risk of non-adherent care, while high-volume hospital treatment (OR=0.59, 95%CI=0.53-0.66) and travel distance to receive care ≥32 km/20 mi (OR=0.80, 95%CI=0.69-0.92) were independently protective. SES was inversely associated with location ≥80 km/50 mi from a high-volume hospital, ranging from 6.3% (high-SES) to 33.0% (low-SES) (p<0.0001). White patients were significantly more likely to travel ≥32 km/20 mi to receive care (21.8%) compared to Blacks (14.4%), Hispanics (15.9%), and Asian/Pacific Islanders (15.5%) (p<0.0001).
conclusionGeographic proximity to a high-volume hospital and travel distance to receive treatment are independently associated with NCCN guideline adherent care for advanced-stage ovarian cancer. Geographic barriers to standard ovarian cancer treatment disproportionately affect racial minorities and women of low-SES.
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