A review of the effects of healthcare disparities on the experience and survival of ovarian cancer patients of different racial and ethnic backgrounds

Abstract

Ovarian cancer (OC) is a serious condition that often presents at advanced stages and has high mortality rates, with the current mode of early-stage screening lacking sensitivity and specificity. OC often presents asymptomatically, which renders early diagnosis difficult. Furthermore, many patients lack significant risk factors or family history of the disease. Five-year survival rates differ between patients with OC among racial, ethnic, and social groups as a result of different social barriers. This review article aims to present the currently existing data regarding health care disparities among OC patients of different ethnic, demographic, and socioeconomic backgrounds, and what next steps should be taken to better understand and eventually eliminate these potentially devastating health care disparities. Increasing data support the notion that a combination of genomic, socioeconomic status, social factors, and cultural differences lead to differential treatments and therefore health care disparities. While genomic and biological factors are important, language barriers, geographic and travel barriers, differences in comorbidity likelihood between populations, and different treatment plans seem to have a greater impact on 5-year survival rates of patients from diverse backgrounds. Language barriers limit a shared-decision model of care. Transportation limitations and geographic differences can lead to limited follow-up and insufficient care in resource and equipment restrictive settings. Patients with these barriers also tend to have a higher incidence of comorbidities that raise the mortality rate of OC. Further research needs to explore effective solutions to bridge health care disparities and understand why they occur.

MiR-200c-3p Contrasts PD-L1 Induction by Combinatorial Therapies and Slows Proliferation of Epithelial Ovarian Cancer through Downregulation of β-Catenin and c-Myc

“…Despite the first-line therapy, the prognosis of EOC patients in terms of five-year survival rate decreases from 90% at stage I to 20% at stage III-IV of the disease. The high mortality rate depends on the obsolete existence of early-stage screening and development of resistance to platinum-based chemotherapy in almost 80% of the patients [ 5 , 6 ]. To overcome therapeutic failures, targeted therapies including the recently FDA approved poly(ADP-ribose) polymerase inhibitors (PARPi), radiotherapy and immunotherapy have been developed [ 7 , 8 ].…”

Using patient experiences to evaluate care and expectations in lung cancer: analysis of the English Cancer Patient Experience Survey linked with the national cancer registry

“…There is a likely contribution of sampling and responder bias that favours people with a better prognosis. Nationally, 15% of the UK lung cancer registry is represented by non-white ethnicity [ 10 , 11 ], whilst this figure was 3.5% of the CPES population, which suggests possible inequities and potential barriers, including language and cultural perceptions [ 26 ]. Receipt of treatment within this study refers to the pathway the individual followed according to healthcare data and may not reflect treatment receipt at the time of survey sampling.…”

Effect of a health literacy training program for surgical oncologists and specialized nurses on disparities in referral to breast cancer genetic testing

“…[4e9] These disparities in referral may lead to differences in treatment and survival rates, because early detection of a pathogenic variant has the potential to improve health outcomes [10]. Besides, carrying a BRCA pathogenic variant implies a change in follow-up measures as these patients may have an increased risk of developing a second breast cancer or ovarian cancer.…”