Racial/Ethnic Disparities in Ovarian Cancer Treatment and Survival: An Integrative Approach

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Project Abstract: This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA-22-057”. Ovarian cancer is the most lethal gynecologic cancer in women in North America, yet our understanding of ovarian cancer etiology, recurrence, and survival in Hispanic women living in Latin America is lacking and our understanding of these factors in US Hispanic women is very limited. To facilitate the evaluation of the unique pathogenesis of ovarian cancer among understudied global populations, we will confirm ovarian cancer cases via medical record linkage and through centralized pathology review to identify the distribution of histotypes in cases from the Mexican Teachers' Cohort (MTC) and compare them with the Hispanic cases from Kaiser Permanente Northern California (KPNC). We will also determine the availability of data on clinical characteristics, treatment patterns, and outcomes for ovarian cancer cases diagnosed in MTC that facilitate future comparative analyses across race and ethnicity subgroups in KPNC. The KPNC population includes US Hispanic cases as one understudied group of interest and this supplemental funding to increase global cancer disparities research will support the inclusion of and comparison with a complementary group of ovarian cancer cases diagnosed among women living in Mexico from the MTC. Specifically, we will leverage the existing resources available in the MTC, including case validation linkages and algorithms developed for breast cancer, and apply them to ovarian cancer, to develop the capacity to evaluate a subset of the parent R01 research aims in the MTC. Importantly the ability to compare histotype distributions and survival of Hispanic women living in California to women living in a culturally, geographically, and economically diverse 12-state region in Mexico will improve the generalizability of our study findings and provide important and relevant data on an understudied and underrepresented population subgroup. Given that self-reported Hispanic ethnicity represents a diverse group with varying traditions and cultural backgrounds, we will also evaluate all comparisons with KPNC cases among the subgroup with self-reported Mexican ethnicity. Strengths of the proposed study include the overlapping study years for the two cohorts (2000-2018 KPNC, 2006-2022 MTC) and centralized pathology review. Additionally, this supplement expands our multi-disciplinary research team to include additional researchers with expertise in complementary areas who are committed to understanding racial and ethnic disparities in ovarian cancer.