Abstract 1911: Racial and ethnic disparities in comorbidity burden among ovarian cancer patients
Authors: Collin Lindsay Jane , Lee Valerie , Li Jia , Diaz Carola Sanchez , Powell Bethan , Kavecansky Juraj , Gomez Scarlett Lin , Doherty Jennifer , Bandera Elisa V. , Kushi Larry 
Published: April 2023

Background: Ovarian cancer is the most lethal gynecologic cancer and the fifth leading cause of cancer-related mortality among women in the US. Racial and ethnic disparities in ovarian cancer outcomes are well-documented, wherein non-Hispanic Black (NHB) women are 40% more likely to die from their disease compared with non-Hispanic White (NHW) women. However, the causes of these disparities are complex and multifactorial. Comorbidities are known to differ by race and ethnicity and have the potential to affect treatment and cancer outcomes. Our objective was to characterize the comorbidity burden by race and ethnicity in a large cohort of ovarian cancer patients.

Methods: The electronic health record-based Kaiser Permanente Research on Ovarian Cancer Survival (KP-ROCS) study includes individuals ≥18 years of age diagnosed with ovarian cancer between 2000 and 2018. Comorbidities (e.g., cardiovascular disease, type II diabetes, hypertension, liver disease) were identified using ICD-9/10 and procedural codes in the five years preceding the individual’s ovarian cancer diagnosis. We present the distribution of individual comorbidities as well as the Charlson Comorbidity Index (CCI) across racial and ethnic groups (non-Hispanic Asian, Hispanic, NHB, and NHW).

Results: Of 4,910 ovarian cancer patients in the KP-ROCS cohort, 625 (13%) are non-Hispanic Asian, 605 (12%) are Hispanic, 268 (5.5%) are NHB, and 3,321 (74%) are NHW. The mean age at diagnosis was lowest for non-Hispanic Asian (57 years, standard deviation [SD] 14), followed by Hispanic (60 years, SD=13), NHB (63 years, SD=13), and NHW (65 years, SD=13) ovarian cancer patients. At diagnosis, NHB and Hispanic ovarian cancer patients were more likely to present with diabetes than non-Hispanic Asian and NHW women (NHB=21%, Hispanic=21% vs non-Hispanic Asian=16%, NHW=12%). Cardiovascular disease was more common among NHB women compared with other racial and ethnic groups (NHB=41% vs. Hispanic=28%, non-Hispanic Asian=26%, NHW=32%). Moreover, the net burden of comorbidities (CCI=3+) was higher among NHB women compared with other racial and ethnic groups (NHB=30% vs non-Hispanic Asian=17%, Hispanic=23%, NHW=21%).

Conclusions: Our preliminary data indicate that NHB ovarian cancer patients are more likely to present with comorbidities at the time of their ovarian cancer diagnosis compared with other racial and ethnic groups. These comorbid conditions may inhibit the ability to tolerate surgery and systemic therapies, contributing to racial and ethnic disparities in outcomes. Future analyses will seek to address these questions.

Citation Format: Lindsay Jane Collin, Valerie Lee, Jia Li, Carola Sanchez Diaz, Bethan Powell, Juraj Kavecansky, Scarlett Lin Gomez, Jennifer Doherty, Elisa V. Bandera, Larry Kushi. Racial and ethnic disparities in comorbidity burden among ovarian cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1911.