Assessment of national cancer care network guideline-adherent treatment differences as a contributor to racial disparities in epithelial and non-epithelial ovarian cancer survival.

Authors

Marilyn Barragan, Shannon MacLaughlan David, Zhengia Chen, Kimberly Richardson, Wenan Qiang, Denana Miodragovic, Caryn E Peterson

Published in

Cancer treatment and research communications. Volume 48. Pages 101307. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

To assess National Comprehensive Cancer Network (NCCN) guideline concordance and survival for epithelial and nonepithelial ovarian cancer in Black and White patients. Guideline-concordant care is defined as treatment consistent with NCCN recommendations based on tumor subtype and stage at diagnosis.
This retrospective study included epithelial and nonepithelial ovarian cancer cases from the National Cancer Database from 2005 to 2015 for patients of White or Black race. Outcomes were NCCN guideline concordance and five-year survival following diagnosis. Factors significantly associated with guideline concordance and five-year survival in bivariate analyses were included in multivariable survival models. Survival was assessed using Kaplan-Meier estimates with log-rank tests, and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.
Concordance with evidence-based treatment guidelines was lower among Black patients with epithelial histotypes, with no racial difference for nonepithelial types. Black patients also had a higher burden of nonepithelial histotypes relative to White patients. After adjustment for clinical and sociodemographic factors, Black patients had a higher risk of death than White patients (HR = 1.15, 95% CI 1.11-1.18), which was attenuated slightly after inclusion of guideline-concordant treatment in the model (HR = 1.13, 95% CI 1.09-1.17).
Guideline-concordant care was associated with racial differences in survival, but the modest association suggests that additional unmeasured factors likely influence outcomes. Limitations include exclusion of cases missing stage, inability to evaluate factors occurring earlier in the treatment trajectory, and absent data regarding the extent of surgical cytoreduction.

PMID:
42424989
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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