Abstract 2144: Disparities in gynecologic cancer survival outcome by treatment facility and region
Authors: Bae Sejong , Pandya Vishruti , Wang Chenguang , Wang Hao , Arend Rebecca C. , Leath Charles A. , Huh Warner K. 
Published: March 2024

Abstract
Objective: To explore five-year survival of patients with gynecologic cancers by region and treatment facility in the United States. Background: Research studies have examined the risk factors associated with gynecologic cancers, specifically cervical, ovarian, and endometrial, incidence and mortality. In addition to older age, Black/African American race, living in south, less income, less education, having comorbidity, stages of cancer, and lack of insurance have reported as risk factors for the incidence and mortality of gynecologic cancers. In addition, prior studies reported the possible effects from the distance to cancer care facilities on gynecologic cancer outcomes indicated varying results. In this study, we explore the impact of distance travelled by region and treatment facility on gynecologic cancer outcomes. Methods: This study aims to assess five-year cervical, ovarian, and endometrial cancer survival. Data were obtained from the National Cancer Database (NCDB) years 2004-2017, only from patients with a minimum 5-year follow-up. Women with races other than White or Black were excluded from the study. Demographics, region, treatment center type, distance to the treatment center, and cancer stage at diagnosis were analyzed by cancer type and 5-year survival status. Multivariate logistic regression model was used to assess the relationship between distance travelled to treatment facility by region and five-year survival. SAS version 9.4 was used for statistical analysis. Results: The distribution of the demographics across the three cancers were similar. Multivariate logistic models showed significant interactions between facility type and region on five-year survival among cervical, ovarian and endometrial cancer patients. Risk factors varied by region and treatment facility type. Age and cancer stage were significantly associated with survival among all cancers. Distance was significantly associated with survival in cervical and endometrial cancers. Conclusion: Cervical cancer patients in the South Atlantic who travel longer distances to Academic/Research Programs have poorer survival. Likewise, patients with endometrial cancer who live in New England region, and travel longer distances to Integrated Network Cancer Programs, as well as those who live in the West North Central region and travel longer distances to Community Cancer Programs have poorer survival. Further research is warranted to explore the specifics of region and treatment center types among different cancers to get a better understanding of the risk factors. Moreover, to improve the clinical outcomes, further study is needed to aim to identify which of these factors are actionable.
Citation Format: Sejong Bae, Vishruti Pandya, Chenguang Wang, Hao Wang, Rebecca C. Arend, Charles A. Leath, Warner K. Huh. Disparities in gynecologic cancer survival outcome by treatment facility and region [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2144.