Teleoncology for gynecologic cancers

Shalowitz, David I.; Smith, Allison G.; Bell, Maria C.; Gibb, Randall K.

doi:10.1016/j.ygyno.2015.06.042

Cited by 28 publications

(23 citation statements)

References 62 publications

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“…These 2 factors, along with negative beliefs about surgery, are thought to explain almost one‐third of the observed racial disparities in lung cancer treatment among black patients . Telemedicine, which would allow specialists to consult on patient cases remotely by telephone and/or video conferencing, is an emerging area that may improve access to quality care in rural or underserved areas and/or may assist patients with receiving care primarily from a chosen and trusted physician . The utility of this method for ovarian cancer in the United States is unknown, however, and effective delivery of ovarian cancer surgical care, which is a key mediator of improved survival, is still being studied in telemedicine models …”

Section: Discussionmentioning

confidence: 99%

Disparities in ovarian cancer survival in the United States (2001‐2009): Findings from the CONCORD‐2 study

Stewart

Harewood

Matz

et al. 2017

Cancer

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BACKGROUND Ovarian cancer is the fifth leading cause of cancer death among women in the United States. This study reports ovarian cancer survival by state, race, and stage at diagnosis using data from the CONCORD-2 study, the largest and most geographically comprehensive, population-based survival study to date. METHODS Data from women diagnosed with ovarian cancer between 2001 and 2009 from 37 states, covering 80% of the US population, were used in all analyses. Survival was estimated up to 5 years and was age standardized and adjusted for background mortality (net survival) using state-specific and race-specific life tables. RESULTS Among the 172,849 ovarian cancers diagnosed between 2001 and 2009, more than one-half were diagnosed at distant stage. Five-year net survival was 39.6% between 2001 and 2003 and 41% between 2004 and 2009. Black women had consistently worse survival compared with white women (29.6% from 2001–2003 and 31.1% from 2004–2009), despite similar stage distributions. Stage-specific survival for all races combined between 2004 and 2009 was 86.4% for localized stage, 60.9% for regional stage, and 27.4% for distant stage. CONCLUSIONS The current data demonstrate a large and persistent disparity in ovarian cancer survival among black women compared with white women in most states. Clinical and public health efforts that ensure all women who are diagnosed with ovarian cancer receive appropriate, guidelines-based treatment may help to decrease these disparities. Future research that focuses on the development of new methods or modalities to detect ovarian cancer at early stages, when survival is relatively high, will likely improve overall US ovarian cancer survival.

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Section: Discussionmentioning

confidence: 99%

Disparities in ovarian cancer survival in the United States (2001‐2009): Findings from the CONCORD‐2 study

Stewart

Harewood

Matz

et al. 2017

Cancer

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“…13 Tele-medicine, which would allow gynecologic oncologists to consult on patient cases via phone- and/or videoconferencing, has been suggested to alleviate this disparity. 3,14 However, this method has yet to be studied for its feasibility or utility in ovarian cancer. In addition, an inherent challenge exists in that ovarian cancer is a surgically managed disease and it is unknown whether providing remote surgical guidance would yield the same results as being the operating surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, an inherent challenge exists in that ovarian cancer is a surgically managed disease and it is unknown whether providing remote surgical guidance would yield the same results as being the operating surgeon. 14 …”

Section: Discussionmentioning

confidence: 99%

Adherence of Primary Care Physicians to Evidence-Based Recommendations to Reduce Ovarian Cancer Mortality

Stewart

Townsend

Puckett

et al. 2016

Journal of Women's Health

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Ovarian cancer is the deadliest gynecologic cancer. Receipt of treatment from a gynecologic oncologist is an evidence-based recommendation to reduce mortality from the disease. We examined knowledge and application of this evidence-based recommendation in primary care physicians as part of CDC gynecologic cancer awareness campaign efforts and discussed results in the context of CDC National Comprehensive Cancer Control Program (NCCCP). We analyzed primary care physician responses to questions about how often they refer patients diagnosed with ovarian cancer to gynecologic oncologists, and reasons for lack of referral. We also analyzed these physicians’ knowledge of tests to help determine whether a gynecologic oncologist is needed for a planned surgery. The survey response rate was 52.2%. A total of 84% of primary care physicians (87% of family/general practitioners, 81% of internists and obstetrician/gynecologists) said they always referred patients to gynecologic oncologists for treatment. Common reasons for not always referring were patient preference or lack of gynecologic oncologists in the practice area. A total of 23% of primary care physicians had heard of the OVA1 test, which helps to determine whether gynecologic oncologist referral is needed. Although referral rates reported here are high, it is not clear whether ovarian cancer patients are actually seeing gynecologic oncologists for care. The NCCCP is undertaking several efforts to assist with this, including education of the recommendation among women and providers and assistance with treatment summaries and patient navigation toward appropriate treatment. Expansion of these efforts to all populations may help improve adherence to recommendations and reduce ovarian cancer mortality.

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“…For example, a virtual tumor board or surgical consultation may provide adequate information for gynecologic cancer treatment planning without a face‐to‐face visit by the patient. This approach would have the dual benefit of saving costs for nonsurgical gynecologic oncology care and expanding the pool of subspecialists with whom the insurer could negotiate reimbursement rates …”

Section: Gynecologic Cancer Care and Network Adequacymentioning

confidence: 99%