Relationship status and other demographic influences on survival in patients with ovarian cancer. Issue 12 (12th September 2020)

• Record Type: Journal Article
• Authors: Gardner, Austin B; Sanders, Brooke E; Mann, Amandeep K; Liao, Cheng-I; Eskander, Ramez Nassef; Kapp, Daniel S; Chan, John K
• Is Part Of: International journal of gynecological cancer. Volume 30:Issue 12(2020)
• Page Start: 1922
• Page End: 1927
• Publication Date: 2020-09-12
• Subjects: ovary -- ovarian cancer; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2020-001512
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: To evaluate the influence of marital status and other demographic factors on survival of patients with ovarian cancer. Study design: Data were obtained from the Surveillance, Epidemiology, and End Results database from 2010 to 2015. Analyses were performed using Kaplan–Meier and multivariate Cox proportional hazard methods. Results: Of 19 643 patients with ovarian cancer (median age 60 years, range 18–99), 16 278 (83%), 1381 (7%), 1856 (9%), and 128 (1%) were White, Black, Asian, and Native American, respectively. The majority of patients (10 769, 55%) were married while 4155 (21%) were single, 2278 (12%) were divorced, and 2441 (12%) were widowed. Patients were more likely to be married if they were Asian (65%) or White (56%) than if they were Black (31%) or Native American (39%) (p<0.001). Most married patients were insured (n=9760 (91%), non-Medicaid) compared with 3002 (72%) of single, 1777 (78%) divorced, and 2102 (86%) of widowed patients (p<0.001). Married patients were more likely to receive chemotherapy than single, divorced, and widowed patients (8515 (79%) vs 3000 (72%), 1747 (77%), and 1650 (68%), respectively; p<0.001). The 5-year disease-specific survival of the overall group was 58%. Married patients had improved survival of 60% compared with divorced (52%) and widowed (44%) patients (p<0.001). On multivariate analysis, older age (HR 1.02, 95% CI 1.016 to 1.021, p<0.001), Black race (HR 1.24, 95% CI 1.11 to 1.38, p<0.001), and Medicaid (HR 1.19, 95% CI 1.09 to 1.30, p<0.001) or uninsured status (HR 1.23, 95% CI 1.05 to 1.44, p<0.01) carried a worse prognosis. Single (HR 1.17, 95% CI 1.08 to 1.26, p<0.001), divorced (HR 1.14, 95% CI 1.04 to 1.25, p<0.01), and widowed (HR 1.16, 95% CI 1.06 to 1.26, p<0.001) patients had decreased survival. Conclusion: Married patients with ovarian cancer were more likely to undergo chemotherapy with better survival rates. Black, uninsured, or patients with Medicaid insurance had poorer outcomes.