Related Experiment Video
Updated: May 10, 2025
Author Spotlight: Advancing Fertility Assessment with Z-Score-Based Follicle Density Evaluation in Cryopreserved Ovarian Tissue
Published on: October 25, 2024
Racial Disparities in Pediatric Ovarian Mass Management
Taylore King1, Kamaria Dansby2, Molly Lavaud2
1Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Black females with ovarian masses underwent oophorectomy more often than White females, despite similar malignancy rates. This suggests potential racial bias in surgical intervention for pediatric ovarian masses.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Health Disparities
Background:
- Social determinants of health, including race and ethnicity, influence pediatric surgical care access and outcomes.
- Limited research exists on how patient race affects surgical interventions for ovarian masses in pediatric females.
Purpose of the Study:
- To investigate the impact of patient race on surgical intervention for ovarian masses in pediatric females.
- To identify potential racial disparities in surgical management and outcomes for this patient population.
Main Methods:
- Retrospective single-institution review (2009-2021) of pediatric females (≤18 years) undergoing surgery for ovarian masses.
- Data collected included socio-demographics, race, preoperative assessments, surgical type, and pathology.
- Fisher's exact test analyzed differences in clinical findings across race groups.
Main Results:
- 409 cases included: 48% White, 41% Black, 11% Other race.
- No significant difference in malignancy rates by race (p=0.862).
- Black patients were significantly more likely to undergo oophorectomy than White patients (p=0.009).
Conclusions:
- Black females with ovarian masses had a higher likelihood of oophorectomy compared to White females, irrespective of malignancy.
- This disparity indicates potential racial bias in surgical decision-making.
- Preoperative risk stratification algorithms may help mitigate biases, warranting further investigation.
Background:
Race, ethnicity, gender and social determinants of health have been found to impact access to pediatric surgical care and outcomes. However, there is limited research examining the effect of patient race on surgical intervention in pediatric females presenting with ovarian masses.
Methods:
A retrospective single-institution cross-sectional review between 2009 and 2021 was performed which included individuals with sex assigned as female at birth ≤18 years of age who underwent surgery for an ovarian mass. Socio-demographics, self-reported race, preoperative imaging and laboratory assessment, type of surgery, and final pathology were collected. Fisher's exact test was used to determine if clinical findings among three race groups and two social determinants of health metrics were different.
Results:
The study included 409 distinct adnexal mass cases. 196 (48 %) of patients identified as White race, 159 (41 %) identified as Black race, and the remaining 44 (11 %) were labelled as Other race. Overall, 383 (93.6 %) cases had benign pathology and there was no difference in rate of malignancy on final pathology by race group (p = 0.862). Black patients were significantly more likely to undergo oophorectomy compared to White patients (p = 0.009). There were no differences in pre-operative evaluation, surgical management, or final pathology based on social determinants of health indices.
Conclusion:
Black females were significantly more likely to undergo oophorectomy compared to White females despite no differences rates of malignancy. The implementation of a preoperative risk stratification algorithm may mitigate racial biases in this population, however, further investigation is needed to address this disparity.
Level Of Evidence:
Level 2.
Related Concept Videos
02:07Oogenesis
01:21Cancer Survival Analysis