Ethnic differences in survival among women with ovarian carcinoma.
BACKGROUND
Ovarian carcinoma is the leading cause of death among all female reproductive malignancies. There are substantial differences in age-adjusted incidence rates and survival rates between Caucasian women and African-American women. The objective of this study was to examine ethnic differences in survival after ovarian carcinoma in a population-based sample of women.


METHODS
Thirteen thousand eighty-three patients (12285 Caucasian women and 798 African-American women) who were diagnosed with primary ovarian carcinoma from the population-based Surveillance, Epidemiology, and End Results (SEER) Program were used for analysis. Odds ratios were used to estimate the association between prognostic variables and ethnicity. Chi-square tests were used to determine the statistical significance of these associations (using two-sided P values). Univariable and multivariable Cox proportional hazards models were used to assess survival differences.


RESULTS
African-American women were significantly younger at the time of diagnosis, were more likely to be single, and were less likely to undergo site specific surgery compared with Caucasian women. In addition, the crude median survival for African-American women was nearly 1 year less than for Caucasian women (22 months vs. 32 months, respectively; P < 0.0001). African-American women were at a 30% increased risk of death from any cause when adjusting for all other prognostic variables that differed between the two ethnic groups.


CONCLUSIONS
African-American women who are diagnosed with ovarian carcinoma are at a significant increased risk of death from any cause compared with Caucasian women who are diagnosed with ovarian carcinoma.
Barnholtz-Sloan
Jill S
JS
Epidemiology Section, Population Studies and Prevention Program, Karmanos Cancer Institute, Detroit, Michigan 48201, USA. barnholz@karmanos.org
Tainsky
Michael A
MA
Abrams
Judith
J
Severson
Richard K
RK
Qureshi
Faisal
F
Jacques
Suzanne M
SM
Levin
Nancy
N
Schwartz
Ann G
AG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002277:Carcinoma / Q000208:ethnology* / Q000401:mortality*; D002423:Cause of Death; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000208:ethnology* / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D016019:Survival Analysis; D044465:White People; D001741:Black or African American