title: Do racial/ethnic disparities exist in the utilization of high-volume surgeons for women with ovarian cancer?
abstract: OBJECTIVE
  Determine if racial/ethnic disparities exist for access to high-volume surgeons (HVS) for patients with ovarian cancer.
  
  
  METHODS
  Retrospective study of ovarian cancer surgeries identified by the California Cancer Registry (CCR) linked to hospital discharge data (1991-2002). Surgeon volume was defined as HVS (>10 ovarian cancer surgeries/year), middle volume (MVS; 2-9/year), and low volume (LVS; </=1/year). Multivariate ordered logistic regression predicting surgeon volume provided estimates of relative risk (RR) of surgeon volume by patient race/ethnicity.
  
  
  RESULTS
  13,186 women had ovarian cancer (mean age 57.8 years; 72% non-Hispanic White (NHW), 4% Black, 8% Hispanic). 25% of cases were treated by HVS, 31% by MVS, and 44% by LVS. Compared to NHW, Black (RR: 0.70, p<0.05) and Hispanic women (RR: 0.75, p<0.05) were less likely to have care by a HVS. Hispanic women were significant more likely to have surgery by LVS (RR: 1.1; p<0.05).
  
  
  CONCLUSIONS
  Disparities in access to HVS for cancer care exist for minority women. Selective referral to high-volume providers should be considered to improve outcomes among minority women.
authors.affiliation: Department of Surgery, the David Geffen School of Medicine at UCLA, 72-215 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Aranda
authors.forename: Marcia
authors.initials: M
authors.lastname: McGory
authors.forename: Evan
authors.initials: E
authors.lastname: Sekeris
authors.forename: Melinda
authors.initials: M
authors.lastname: Maggard
authors.forename: Clifford
authors.initials: C
authors.lastname: Ko
authors.forename: David S
authors.initials: DS
authors.lastname: Zingmond
mesh_terms: D001741:Black or African American; D005006:Ethnicity; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000592:standards / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000208:ethnology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D044465:White People