Exploring Disparities and Ovarian Cancer

When talking about medical conditions and who is most affected by them, people sometimes use the word disparity. A disparity is simply another word difference.

When talking about ovarian cancer, there are disparities in:

• Who gets this type of cancer
• The stage at which their cancers are diagnosed
• Who gets access to the best treatments
• Who is most likely to die from it

These differences can add up and have a big impact on ovarian cancer. Since ovarian cancer does not have clear symptoms and can be hard to diagnose in its early stages, delays in screening or gaps in care often mean the disease is diagnosed at a later stage. This makes it harder to treat. It also means that people may not benefit equally from the latest innovations in care.¹

It is important to understand not only which disparities exist, but why they do. For example, people of different races and ethnicities can be more likely to die from a certain disease. But that does not always mean that people of a particular race are naturally more likely to get sick. Health is often the result of a complex mix of factors – biology is just one factor. Disparities are most often the result of combinations of factors, but we do see patterns. Understanding these patterns gets us closer to improving healthcare for everyone.^2,3

Here, we take a deeper look at how a range of factors can affect a person’s experience with ovarian cancer.

Race and ovarian cancer

When looking at disparities in ovarian cancer, race and ethnicity are an important place to start. Racial and ethnic disparities in disease are often the result of a legacy of discrimination that persists to this day.

Current data show that non-Hispanic white women are more likely to be diagnosed with ovarian cancer than Black or Hispanic women. However, non-Hispanic Black women have a higher risk of dying from ovarian cancer compared to white women.5 This risk was even higher in people diagnosed with ovarian cancer before the age of 50. Hispanic women have about the same level of risk as white women, while Asian and Pacific Islander women have a reduced risk.^4,5

Looking closer at the data, we can see that Black women are more likely to be diagnosed late. This means that the cancer will have had time to progress before treatment begins. Black women are also more likely to be diagnosed with a higher stage of ovarian cancer. This points to problems in healthcare access, which mostly affect people of color due to systemic discrimination.^2,4

Quality of care

Lack of access to healthcare results in another disparity related to quality of cancer care. Research shows that when Black and white people get the same ovarian cancer treatments, their outcomes are the same. However, people of color are less likely to get care that follows treatment guidelines, including:^2,3,5

• Black and Hispanic women are less likely than white women to get ovarian cancer surgery
• Black women were more likely than non-Hispanic white women to get lower doses of chemotherapy, experience delays in treatment, and stop treatment too soon
• People of color are less likely to get advanced ovarian cancer treatments

Where you live

If you have to travel a long distance for ovarian cancer screening or treatment, you may not be able to get the care you need. Research shows that having access to a large hospital system that treats many cases of ovarian cancer each year can give you an advantage. Studies also show that having to travel more than 20 miles for care increased the chance that a person would not be able to get to every cancer care appointment or get proper follow-up care.²

Your environment can also affect your cancer care. This includes the places and things you are exposed to in your daily routine. Pesticides and herbicides have been linked to ovarian cancer. You do not have to live near a farm to be exposed to these chemicals – they can get into groundwater.²

Another chemical of concern might be in your own bathroom: talc. When it is applied to the genitals, it is possible talc can cause ovarian cancer.²

Your body and genes

One of the biggest breakthroughs in understanding ovarian cancer was the discovery that mutations in the BRCA1 and BRCA2 genes raise the risk of certain cancers. These gene mutations can be passed down to new generations. This happens to Black women at a higher rate than women of other races.²

People of color may also face a higher rate of comorbidities. These are other diseases or conditions that a person may have in addition to cancer. Studies show that Black women who are diagnosed with ovarian cancer are more likely to also have high blood pressure, heart disease, or kidney disease. Having these illnesses can affect your cancer care.²

There is also a well-known connection between cancer and inflammation. Inflammation is the way the body reacts to damage. Swelling, heat, pain, and redness are some signs of inflammation. We now know that certain foods can cause inflammation in some people. Studies show that eating foods that cause inflammation can increase the risk of ovarian cancer in Black women. Eating a lot of carbohydrates (starchy, sugary foods) also raised the risk. Talk to your doctor about the foods that might cause inflammation in your body.²

Eliminating disparities

Understanding why disparities exist is an important step in solving them. Many of the disparities listed in this article can be fixed by expanding access to good-quality healthcare.^2,3

If you are a woman of color, it is important to examine whether your care meets treatment standards. If you are unable to follow through with any appointments or treatment recommendations, ask your doctor about services that can help you get the care you need.