Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Demetra H Hufnagel; Dineo Khabele; Fiona E Yull; Pamela C Hull; Joellen Schildkraut; Marta A Crispens; Alicia Beeghly-Fadiel

doi:10.1016/j.canep.2021.102013

Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Cancer Epidemiol. 2021 Oct:74:102013. doi: 10.1016/j.canep.2021.102013. Epub 2021 Aug 23.

Authors

Demetra H Hufnagel¹, Dineo Khabele², Fiona E Yull³, Pamela C Hull⁴, Joellen Schildkraut⁵, Marta A Crispens⁶, Alicia Beeghly-Fadiel⁷

Affiliations

¹ Vanderbilt University School of Medicine, Nashville, TN 37240, USA; Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA 90095, USA.
² Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO 63130, USA.
³ Department of Pharmacology, Vanderbilt University, Nashville, TN 37212, USA; Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA.
⁴ Division of Population Science and Community Impact, University of Kentucky, Markey Cancer Center, Lexington, KY 40536, USA.
⁵ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
⁶ Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA.
⁷ Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: alicia.beeghly@vumc.org.

Abstract

Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources.

Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression.

Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively.

Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.

Keywords: Ovarian neoplasms; Prognosis; Socioeconomic factors; Survival.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Ovarian Epithelial / epidemiology
Female
Humans
Ovarian Neoplasms* / epidemiology
Progression-Free Survival
Proportional Hazards Models
Residence Characteristics
Social Class

Abstract

Publication types

MeSH terms

Grants and funding