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Demographic, presentation, and treatment factors and racial disparities in ovarian cancer hospitalization outcomes

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Abstract

Background

This study examines whether racial disparities in hospitalization outcomes persist between African–American and White women with ovarian cancer after matching on demographic, presentation, and treatment factors.

Methods

Using data from the Nationwide Inpatient Sample database, 5,164 African–American ovarian cancer patients were sequentially matched with White patients on demographic (e.g., age, income), presentation (e.g., stage, comorbidities), and treatment (e.g., surgery, radiation) factors. Racial differences in-hospital length of stay, post-operative complications, and in-hospital mortality were evaluated using conditional logistic regression models.

Results

White ovarian cancer patients had relatively higher odds of post-operative complications when matched on demographics (OR 1.35, 95% CI 1.05, 1.74), and presentation (OR 1.28, 95% CI 1.00, 1.65) but not when additionally matched on treatment (OR 1.03, 95% CI 0.78, 1.35). African–American patients had longer in-hospital length of stay (6.96 ± 7.21 days) compared with White patients when matched on demographics (6.37 ± 7.07 days), presentation (6.48 ± 7.16 days), and treatment (6.53 ± 7.59 days). Compared with African–American patients, White patients experienced lower odds of in-hospital mortality when matched on demographics (OR 0.78, 95% CI 0.66, 0.92), but this disparity was no longer significant when additionally matched on presentation (OR 0.88, 95% CI 0.75, 1.04) and treatment (OR 0.95, 95% CI 0.81, 1.12).

Conclusion

Racial disparities in ovarian cancer hospitalization outcomes persisted after adjusting for demographic and presentation factors; however these differences were eliminated after additionally accounting for treatment factors. More studies are needed to determine the factors driving racial differences in ovarian cancer treatment in otherwise similar patient populations.

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Authors and Affiliations

  1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Tomi F. Akinyemiju, Gurudatta Naik & Kemi Ogunsina

  2. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Tomi F. Akinyemiju & Gurudatta Naik

  3. Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA

    Tomi F. Akinyemiju & Daniel T. Dibaba

  4. University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA

    Neomi Vin-Raviv

  5. School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, USA

    Neomi Vin-Raviv

Authors
  1. Tomi F. Akinyemiju
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  2. Gurudatta Naik
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  3. Kemi Ogunsina
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  4. Daniel T. Dibaba
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  5. Neomi Vin-Raviv
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Correspondence to Tomi F. Akinyemiju.

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Akinyemiju, T.F., Naik, G., Ogunsina, K. et al. Demographic, presentation, and treatment factors and racial disparities in ovarian cancer hospitalization outcomes. Cancer Causes Control 29, 333–342 (2018). https://doi.org/10.1007/s10552-018-1010-7

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  • DOI: https://doi.org/10.1007/s10552-018-1010-7

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