Investigators Identify Factors Behind US Ovarian Cancer Mortality Disparities, Propose Targeted Solutions

In this clip, 2 investigators from the study, "Demographic Trends in Mortality Due to Ovarian Cancer in the United States, 1999-2020," expand on what their team member, Muhammad Faizan, MBBS, shared in parts 1 and 2 regarding its key findings and the factors contributing to the significant decline in age-adjusted ovarian cancer mortality rates after 2003.

Ali Shan Hafeez, a fourth-year MBBS student and undergraduate research intern at the CMH Multan Institute of Medical Sciences in Pakistan, discusses possible reasons for the disparities observed across age, race, and geographic regions.

Building on this, Abdul Rafae Faisal, MBBS, of the CMH Multan Institute of Medical Sciences, recommends public health and clinical interventions that may help reduce these mortality disparities.

This transcript was lightly edited; captions were auto-generated.

Transcript

What are the possible reasons behind the persistent disparities across age, race, and geographic regions that you observed?

Hafeez: The persistent disparities in ovarian cancer mortality are multifactorial and include several key reasons. If we look at age-related disparities, older women, especially those 65 and above, experience significantly higher mortality rates, partly due to delayed diagnosis, and they are less likely to receive aggressive treatments.

If we talk about racial and ethnic disparities, non-Hispanic White women exhibit the highest overall ovarian cancer mortality rates and a higher prevalence of genetic risk factors, such as BRCA mutations. Black and Hispanic women often face worse outcomes after diagnosis, largely due to systemic health care inequities, such as limited access to timely specialist care and socioeconomic barriers affecting health care utilization. The combination of delayed diagnosis and limited access to advanced treatments leads to poorer survival outcomes for these groups.

If we talk about geographic disparities, mortality rates vary significantly by geographic location. Generally, women in rural and non-metropolitan areas experience higher mortality rates due to the limited availability of specialized oncology services and socioeconomic factors. Regions such as the Northeast and Midwest consistently show higher ovarian cancer mortality rates because of a greater percentage of older and non-Hispanic White populations.

What targeted public health or clinical interventions would you recommend to reduce the mortality disparities highlighted by your research?

Faisal: I think we need to go for a multi-pronged approach towards tackling this problem. First of all, I think we need to go for expanded genetic counseling. We need to counsel families that have a history of BRCA1 mutations. As you know, they tend to run in families. Similarly, we need to target racial groups who are more vulnerable to having this mutation. If we can do that, we can improve surveillance, we can go for prophylactic salpingo-oophorectomies, and that would nip the evil in the bud, as you would say.

Similarly, we need to improve insurance coverage for at-risk demographics and racial groups. What that would do is help us catch it early, and that is the cornerstone of improved ovarian cancer treatment outcomes. Finally, I think we need to change our one-size-fits-all approach and go towards a more individualized treatment [strategy] and treat people as they are and speak in languages that they understand. I think we need to go for culturally sensitive awareness campaigns. I think that would help a lot.

These are a few things I'm sure that would help reduce the burden of a problem that we've already tackled quite well and would go a long way towards improving the outcomes further.