Regional Variation in Access to Oncologic Care and Racial Disparities Among Cervical Cancer Patients

Area of Science:

• Gynecologic Oncology
• Health Services Research
• Health Disparities

Background:

• Access to specialized cancer care, such as gynecologic oncologists, is crucial for optimal patient outcomes.
• Regional and racial disparities in cancer treatment and survival are well-documented but require further investigation into underlying causes.

Purpose of the Study:

• To investigate the correlation between access to gynecologic oncologists and treatment disparities in cervical cancer patients.
• To identify if racial and regional factors exacerbate these disparities, particularly for Black women.

Main Methods:

• An ecological study utilizing the National Cancer Database (2004-2014) for cervical cancer patients (Stage I-IVA).
• Analysis included regional access to care data and factors associated with optimal treatment using multivariate logistic regressions.
• Cox multivariate survival analyses were performed, stratified by region, to assess mortality risks.

Main Results:

• Southern women were less likely to receive optimal cervical cancer treatment compared to Northeastern women.
• Black women in the South and Midwest showed significantly lower odds of receiving optimal treatment.
• Black women in the South and West experienced worse mortality outcomes, even after controlling for gynecologic oncologist availability.

Conclusions:

• Southern women are at increased risk for suboptimal cervical cancer treatment, with Black Southern women facing even greater risks.
• Racial and regional disparities in cervical cancer outcomes persist, indicating that factors beyond gynecologic oncologist access, such as social determinants of health, are significant contributors.