Potential Strategies to Increase Gynecologic Oncologist Treatment for Ovarian Cancer

Abstract

Evidence shows that treatment by gynecologic oncologists (GOs) increases overall survival among women with ovarian cancer. However, specific strategies for institutions and community-based public health programs to promote treatment by GOs are lacking. To address this, we conducted a literature review to identify evidence-based and promising system- and environmental-change strategies for increasing treatment by GOs, in effort to ensure that all women with ovarian cancer receive the standard of care. We searched for English-language literature published from 2008 to 2018. We used PubMed, PubMed Central, OVID, and EBSCO for peer-reviewed literature and Google and Google Scholar for gray literature related to increasing receipt of care by GOs among ovarian cancer patients. Numerous suggested and proposed strategies that have potential to increase treatment by GOs were discussed in several articles. We grouped these approaches into five strategic categories: increasing knowledge/awareness of role and importance of GOs, improving models of care, improving payment structures, improving/increasing insurance coverage for GO care, and expanding or enhancing the GO workforce. We identified several strategies with the potential for increasing GO care among ovarian cancer patients, although currently there is little evidence regarding their effectiveness across US populations. Public health programs and entities that measure delivery of quality health care may pilot the strategies in their populations. Certain strategies may work better in certain environments and a combination of strategies may be necessary for any one entity to increase GO ovarian cancer care. Findings, lessons learned, and recommendations from implementation projects would inform community and public health practice.

Keywords: gynecologic oncologist; ovarian cancer; referral.

FIG. 1.

Multistep review process for peer-reviewed and gray literature. *At each stage, the title, abstract, or article was assessed for evidence of the following: (1) published in English. (2) Published within the past 10 years (2008–2018). (3) Included information regarding facilitators or barriers to receipt of ovarian cancer care from a GO. (4) Included information regarding recommended strategies to increase receipt of ovarian cancer care from a GO. Articles that did not appear to meet these criteria or include the requisite information were excluded. GO, gynecologic oncologist.