Racial disparities in ovarian cancer surgical care: A population-based analysis
Racial disparities in ovarian cancer surgical care: A population-based analysis
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DOI：
10.1016/j.ygyno.2010.12.347
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发表时间：
2011-05-01
影响因子：
4.7
通讯作者：
Ibeanu, Okechukwu A.
中科院分区：
文献类型：
--
作者：
Bristow, Robert E.;Zahurak, Marianna L.;Ibeanu, Okechukwu A.
Objective.研究不同种族的初次卵巢癌手术妇女中卵巢癌相关手术频率和高手术量提供者的差异。访问马里兰州卫生服务成本审查委员会数据库，以了解在2001年7月1日至2009年6月30日期间接受手术（包括因恶性卵巢肿瘤进行卵巢切除术）的年龄> 18岁的女性。采用多变量logistic回归分析，根据种族分类，评估选择外科手术的可能性和获得高容量手术提供者（外科医生>= 10例/年;医院>= 20例/年）的可能性。共确定了2487例接受初次手术（包括卵巢切除术）治疗恶性卵巢肿瘤的患者：白色= 1884例（75.4%），非洲裔美国人= 400例（16.1%），其他/未知= 203例（8.2%）。与白色患者相比，非裔美国患者明显更年轻（平均年龄55.4岁vs 59.9岁，P < 0.0001），购买商业保险的可能性更低（28.5% vs 39.5%，P < 0.0001）。与白色患者相比，非裔美国人的种族分类与子宫切除术的可能性降低相关，具有统计学显著性和独立性（OR = 0.53，95%CI = 0.42-0.66，p < 0.0001），结肠切除术（OR = 0.65，95%CI = 0.48-0.87，p = 0.004），淋巴结切除术（OR = 0.67，95%CI = 0.50-0.91，p = 0.01），以及由大手术量的外科医生进行手术（OR = 0.55，95%CI = 0.44-0.69，p < 0.0001）。在接受卵巢癌初次手术的女性中，与白色患者相比，非洲裔美国患者接受大手术量外科医生手术的可能性显着降低，并接受重要的卵巢癌特异性手术。(C)2010年爱思唯尔公司All rights reserved.
Objective. To investigate differences according to racial classification in the frequency of ovarian cancer-related surgical procedures and in access to high-volume surgical providers among women undergoing initial surgery for ovarian cancer.Methods. The Maryland Health Services Cost Review Commission database was accessed for women age > 18 years undergoing a surgical procedure that included oophorectomy for a malignant ovarian neoplasm between 7/1/01 and 6/30/09. Multivariate logistic regression analyses were used to evaluate for differences in the likelihood of selected surgical procedures and access to high-volume surgical providers (surgeons >= 10 cases/year; hospitals >= 20 case/year) according racial classification.Results. A total of 2487 patients were identified who underwent a primary surgical procedure that included oophorectomy for a malignant ovarian neoplasm: White = 1884 (75.4%), African-American = 400 (16.1%), and other/unknown = 203 (8.2%). Compared to White patients, African-American patients were significantly younger (mean age 55.4 years vs 59.9 years, P < 0.0001) and less likely to have commercial insurance (28.5% vs 39.5%, p < 0.0001). Compared to White patients, African-American racial classification was associated with a statistically significant and independent lower likelihood of hysterectomy (OR = 0.53, 95% CI = 0.42-0.66, p < 0.0001), colon resection (OR = 0.65, 95%CI = 0.48-0.87, p = 0.004), lymphadenectomy (OR = 0.67, 95%CI = 0.50-0.91, p = 0.01), and surgery by a high-volume surgeon (OR = 0.55, 95%CI = 0.44-0.69, p < 0.0001).Conclusions. Among women undergoing initial surgery for ovarian cancer, African-American patients are significantly less likely to be operated on by a high-volume surgeon and to undergo important ovarian cancer-specific surgical procedures compared to White patients. (C) 2010 Elsevier Inc. All rights reserved.