Differences in overall survival for invasive epithelial ovarian cancer by race and ethnicity: results from the Ovarian Cancer Association Consortium

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BACKGROUND: Prior studies have examined survival in patients with epithelial ovarian cancer (EOC); however, few consider race and ethnicity, particularly disaggregating Asian and Native Hawaiian/Pacific Islander women. METHODS: We analysed data from 18 Ovarian Cancer Association Consortium studies, including women with EOC from Asian (n = 697), non-Hispanic Black (n = 267), Hispanic (n = 492), Native Hawaiian/Pacific Islander (n = 98) and non-Hispanic White (n = 12,998) racial and ethnic groups. We ran Cox proportional hazards models estimating overall survival by race and ethnicity, adjusting for age, stage, year of diagnosis, and histotype, with fully adjusted models accounting for body mass index, smoking, and postmenopausal hormone use. We also examined associations between hormone-related factors and family history and overall survival by race and ethnicity, testing for heterogeneity. RESULTS: Compared to non-Hispanic White women with EOC, Native Hawaiian/Pacific Islander and non-Hispanic Black women had poorer overall survival (Hazard Ratios, HR = 1.58, 95% CI = 1.16-2.16, and HR = 1.31, 95% CI = 1.12-1.54, respectively). The association was more pronounced for Native Hawaiian/Pacific Islander women with high-grade serous carcinoma (HR = 2.00, 95% CI = 1.37-2.92). There was no significant heterogeneity in the associations between epidemiological factors and survival by racial and ethnic groups (p ≥ 0.31). DISCUSSION: Native Hawaiian/Pacific Islander and non-Hispanic Black women with EOC had poorer survival, highlighting the need to address disparities in outcome.

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