Closing Gaps in Ovarian Cancer

In recognition of Ovarian Cancer Awareness Month, CDC’s Sherri Stewart, PhD, an ovarian cancer expert in the Division of Cancer Prevention and Control, teams up with Audra Moran, President and CEO of the Ovarian Cancer Research Fund Alliance (OCRFA), to spotlight ovarian cancer treatment. They discuss the current state of treatment and improvements that can reduce deaths from ovarian cancer among all women.

In 2016, with support from CDC, the National Academy of Medicine (formerly known as the Institute of Medicine) published an ovarian cancer consensus study that called on research and clinical communities to work together to help ensure that all women receive the recommended, standard treatment for ovarian cancer. Standard treatment for ovarian cancer includes comprehensive, debulking surgery to remove as much of the tumor as possible, as well as chemotherapy with drugs including a platinum agent (carboplatin/cisplatin) and paclitaxel. Providing the most effective chemotherapy to women has the potential to reduce deaths from ovarian cancer substantially.

While ovarian cancer is diagnosed at far greater numbers in white women compared with women of other races, research has shown that black women have worse survival than white women. A recent review of several studies shows that black women are more likely to be diagnosed in later stages, and less likely to receive recommended surgery and chemotherapy.The reasons for these differences are unknown. However, not having access to the best cancer hospitals or gynecologic oncologists, who are specially trained to treat ovarian cancer, may be part of the problem.

CDC research has shown that gynecologic oncologists are more concentrated in urban areas than rural areas, death rates from ovarian cancer are higher in areas with relatively few gynecologic oncologists, and death rates increase with increasing distance from areas where gynecologic oncologists are concentrated. Access to care also may be affected by insurance or other financial-related barriers. Policymakers, researchers, and the public health community continue to work to identify the underlying reasons and lessen their effects on treatment receipt. However, there continue to be concerns that some women with ovarian cancer may be falling farther and farther behind.

OCRFA is doing its part. As the largest global full-spectrum organization dedicated to ovarian cancer, OCRFA is engaged at every level, from helping drive new discoveries through investing in research, to educating medical residents, and connecting patients and survivors with boots-on-the ground support, regardless of ZIP Code. Last year, OCRFA convened a health care summit to consider ways to address differences in treatment and in fall 2017 is launching a virtual peer-to-peer matching program, connecting newly diagnosed patients to survivor mentors anywhere across the country.

CDC is working with its National Comprehensive Cancer Program (NCCCP) to translate the research findings on gynecologic oncologists. NCCCP grantees in selected states will work with CDC researchers to implement an ovarian cancer action plan that incorporates health system and environmental changes to ensure all women get the recommended treatment for ovarian cancer.

Additionally, CDC continues to assess ovarian cancer treatment systematically among all communities of women in the United States. CDC has conducted population-based ovarian cancer treatment studies since 2003 in diverse populations across the country. CDC uses ovarian cancer patient data from more than 6,000 patients in big cities, the rural South, and the Midwestern region of the U.S. (where gynecologic oncologists are less concentrated) to identify women who have not received recommended treatment, and explore the reasons why.

As part of its national campaign to educate the public, Inside Knowledge About Gynecologic Cancer, CDC continues to highlight the symptoms of ovarian cancer, when to seek treatment for symptoms, and stresses the need for women newly diagnosed with ovarian cancer to seek care from a gynecologic oncologist.

Working together, we can close the gaps in ovarian cancer and ensure that more women with ovarian cancer have access to or receive the recommended treatment for ovarian cancer.