title: Trends in the receipt of guideline care and survival for women with ovarian cancer: A population-based study.
abstract: We assessed trends in the receipt of guideline care and 2-year cause-specific survival for women diagnosed with ovarian cancer.
  
  
  
  This retrospective cohort analysis used National Cancer Institute's Patterns of Care studies data for women diagnosed with ovarian cancer in 2002 and 2011 (weighted n=6427). Data included patient characteristics, treatment type, and provider characteristics. We used logistic regression to evaluate the association of year of diagnosis with receipt of guideline surgery, multiagent chemotherapy, or both. Two-year cause-specific survival, 2002-2013, was assessed using SEER data.
  
  
  
  The adjusted rate of women who received stage-appropriate surgery, 48%, was unchanged from 2002 to 2011. Gynecologic oncologist (GO) consultations increased from 43% (2002) to 78% (2011). GO consultation was a significant predictor for receipt of guideline care, although only 40% of women who saw a GO received guideline surgery and chemotherapy. The percent of women who received guideline surgery and chemotherapy increased significantly from 32% in 2002 to 37% in 2011. From 2002 to 2011, 2-year cause-specific ovarian cancer survival was unchanged for Stages I-III cancers, with slight improvement for Stage IV cancers.
  
  
  
  Receipt of guideline care has improved modestly from 2002-2011 for women with ovarian cancer. Current treatment is far below clinical recommendations and may explain limited improvement in 2-year cause-specific survival. Most women consulted a GO in 2011 yet did not receive guideline care. There needs to be a better understanding of the decision-making process about treatment during the consultation with GOs and other factors precluding receipt of guideline care.
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States. Electronic address: Joan_warren@nih.gov.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Warren
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Harlan
authors.affiliation: Center for Global Health, National Cancer Institute, Bethesda, MD, United States.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Trimble
authors.affiliation: Information Management Services, Calverton, MD, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stevens
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States.
authors.forename: Melvin
authors.initials: M
authors.lastname: Grimes
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Cronin
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant / Q000592:standards / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology
keywords: Guideline care; Ovarian cancer; Survival; Treatment; Trends