Racial Disparities in Non-Recommendation of Adjuvant Chemotherapy in Ovarian Cancer
In a recent study from Gynecologic Oncology, the authors identified ovarian cancer patients who underwent primary surgery from 2004 to 2015. They evaluated factors related to a contraindication (a circumstance that suggests that a particular surgery or drug should not be used) to chemotherapy attributed to patient risk factors (a co-morbid conditions, advanced age). In the 48,245 patients who met the inclusion criteria, 522 (1.08%) did not receive adjuvant (following surgery) chemotherapy because it was determined to be contraindicated.
The reasons for not receiving a recommendation for adjuvant chemotherapy were age ≥ 70 years old, increased number of patient risk factors, and Black race. For Black patients, a recommendation against adjuvant chemotherapy occurred at a younger median age (64.5 years vs. 72 years) and was associated with lower 5-year survival (25.9% vs. 40.3%). Black patients were disproportionately not recommended for chemotherapy, which was associated with worse survival.
However, determining eligibility for adjuvant chemotherapy requires an individualized approach, and thus, the possible influence of racial bias should be further investigated.
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