Multilevel Predictors of Disparities in Ovarian Cancer Outcomes

Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer related mortality among women in the US. Despite advances in surgical approaches and systemic therapies, overall survival has improved only marginally over the past thirty years. Moreover, there are robust and well-documented disparities in EOC mortality. Factors that are thought to contribute to these disparities include access to and quality of care, disease severity, and socioeconomic factors. Still, accounting for these characteristics in multivariable-adjusted models fails to fully explain the observed disparity. Therefore, a more comprehensive examination of factors that impact the inequity in a diverse sample is vital to identify points of intervention and improve EOC survivorship. EOC is a heterogeneous disease with distinct histotypes that inform prognosis. High-grade serous carcinoma (HGSC) is the most common histotype, comprising 70% of all EOC diagnoses. Recently, three robust gene expression signatures have been developed that have the potential to inform risk assessment and biomarker-driven therapeutic approaches for HGSC patients. Each signature correlates to differential survival, suggesting utility in informing HGSC prognosis and guiding treatment intensity. However, no study has compared the performance of these tumor gene expression signatures across populations. Evaluation of these gene expression signatures is important for understanding the clinical implications. In this presentation, Dr. Collin will present work related to her NCI-funded K99/R00, which seeks to understand sociocontextual, patient demographic, clinicopathologic, and molecular features associated with disparities EOC outcomes. She will present work related to factors that contribute to disparities leveraging data from Kaiser Permanente Northern California.