Global ovarian cancer health disparities

Abstract

Objective: The objective of this article is to broadly review the scientific literature and summarize the most up-to-date findings on ovarian cancer health disparities worldwide and in the United States (U.S.).

Methods: The present literature on disparities in ovarian cancer was reviewed. Original research and relevant review articles were included.

Results: Ovarian cancer health disparities exist worldwide and in the U.S. Ovarian cancer disproportionately affect African American women at all stages of the disease, from presentation through treatment, and ultimately increased mortality and decreased survival, compared to non-Hispanic White women. Increased mortality is likely to be explained by unequal access to care and non-standard treatment regimens frequently administered to African American women, but may also be attributed to genetic susceptibility, acquired co-morbid conditions and increased frequency of modifiable risk factors, albeit to substantially lesser extent. Unequal access to care is, in turn, largely a consequence of lower socioeconomic status and lack of private health insurance coverage among the African American population.

Conclusions: Our findings suggest the need for policy changes aimed at facilitating equal access to quality medical care. At the same time, further research is necessary to fully resolve racial disparities in ovarian cancer.

Fig. 1

Incidence of ovarian cancer by world region. GLOBOCAN 2008 data. Complete list of countries included in the world regions, is shown in Appendix A. NZ: New Zealand; S.E. Asia: South-Eastern Asia; S.C. Asia: South-Central Asia.

Fig. 2

A. Ovarian cancer incidence (open symbols) and mortality (closed symbols) rates worldwide (stars) and in the U.S. (circles). B. Mortality/incidence (M/I) ratios. Average worldwide rates were calculated using the GLOBOCAN 2008 database [18]: NHW (Non-Hispanic White) women — Northern, Central, Eastern and Western Europe;H (Hispanic) women — Central and South Americas and Mexico; A (African) women — North and Middle Africa; An (Asian) women — South-East, South-Central and East Asia.