Racial/ethnic differences in the use of surgery for ovarian cancer in the United States

ABSTRACTPurposeThis study provides an assessment of patterns of both hysterectomy and other surgeries among ovarian cancer patients in the United States according to race/ethnicity.MethodsAnalyses are based on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, 2002 through 2006.ResultsAbout 75% of ovarian cancer patients received surgery, with most undergoing unilateral or bilateral (salpingo-) oophorectomy with omentectomy or debulking (cytoreductive surgery). Black and Hispanic patients were significantly less likely to receive surgery after adjusting for age, marital status, and tumor stage and grade at diagnosis. Among cases aged 15–44 with localized disease, 35% selected fertility-conservative management. The percentage receiving fertility-conservativemanagement fell from 57% in ages 15–29 to 12% in ages 40–44. There was no significant difference among women of childbearing age across racial/ethnic classifications in their use of fertility-conservative management. Among the 88% of patients aged 45 years or older at diagnosis, treatment with surgery was generally high: 90% for ages 45–59, 81% for ages 60–69, 68% for ages 70–79, and 38% for ages 80 and older.ConclusionBlack and Hispanic patients are less likely to receive surgery, but in women of childbearing age with locally staged disease there is no difference among racial/ethnic groups in fertility-conservative management.