Impact of Marginalization Dimensions on Survival Disparities in Epithelial Ovarian Cancer: An Ontario Population-Based Study
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Le résumé fourni par la source
Objectives: We aimed to examine associations between social marginalization, defined by the Ontario Marginalization Index (“ON-Marg”), and overall survival (OS) in epithelial ovarian cancer (EOC). Methods: This was a population-based retrospective cohort study using linked administrative data in Ontario, Canada, including adults ≥ 18 years diagnosed with stage II-IV EOC (2010–2022). ON-Marg dimensions included Material Resources (economic disadvantage), Households and Dwellings (housing type/density), Age and Labour Force (workforce participation), and Racialized and Newcomer Populations (recent immigrants/visible minorities), and were categorized into quintiles (Q1 least marginalized, Q5 most marginalized). The primary outcome was OS. Multivariable Cox models estimated adjusted hazard ratios (aHR) for each ON-Marg dimension. Wald χ2 statistics identified the dimension most strongly associated with OS. Results: Material Resources was most strongly associated with OS. Compared with Q1 (least marginalized), higher mortality was observed in Q3 (aHR 1.10; 95%CI 1.02–1.19), Q4 (aHR 1.13, 95%CI 1.05–1.22), and Q5 (aHR 1.25, 95%CI 1.15–1.35). Greater marginalization in the Racialized and Newcomer Populations dimension was associated with improved OS (Q5 aHR 0.87, 95%CI 0.80–0.94). The association between Material Resources and OS persisted in patients undergoing cytoreductive surgery with chemotherapy, but not among those receiving chemotherapy alone or no treatment. Conclusions: Material Resources is an independent predictor of survival in EOC within a universal, publicly funded healthcare system, with greatest impact among patients undergoing multimodal oncologic care. Residence in highly racialized or newcomer communities was associated with improved survival. Material marginalization is highlighted as a key driver of inequity, supporting targeted system-level interventions to address financial and logistical barriers to care.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of Marginalization Dimensions on Survival Disparities in Epithelial Ovarian Cancer: An Ontario Population-Based Study
- Date Crossref
- 10/06/2026
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Toronto Department of Obstetrics and Gynecology pays non établi dans la noticeUniversité ou école supérieure
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Sunnybrook Health Science Centre pays non établi dans la noticeÉtablissement de santé
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Princess Margaret Cancer Centre pays non établi dans la noticeÉtablissement de santé
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Schwartz/Reisman Emergency Medicine Institute pays non établi dans la noticeOrganisation à but non lucratif
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Division of Gynecologic Oncology pays non établi dans la noticeInstitution
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ICES Central pays non établi dans la noticeInstitution
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Institute of Health Policy pays non établi dans la noticeStructure de recherche
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University Health Network Princess Margaret Cancer Centre pays non établi dans la noticeUniversité ou école supérieure
Department of Obstetrics and Gynecology — University of Toronto, Sunnybrook Health Science Centre et Princess Margaret Cancer Centre, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.