Association of social vulnerability with access to treatment in ovarian cancer patients

Abstract

Objectives

To understand disparities in access to treatment for ovarian cancer patients.

Methods

A retrospective review of patients who had surgery for ovarian cancer at a comprehensive cancer center from 2018 to 2024 was completed. Social Vulnerability index quartiles generated by patients’ zip codes were used as measures of social vulnerability. Social vulnerability encompasses four themes, including socioeconomic status, household characteristics, racial/ethnic minority status, and housing type and transportation. The primary outcome was time to treatment initiation. Secondary outcomes included time to chemotherapy, time to surgery, time to palliative care treatment, and progression-free survival. Logistic regression was used to assess the relationship between social vulnerability and treatment access.

Results

Among 166 ovarian cancer patients, there was a trend towards increased time from diagnosis to treatment amongst patients with the highest social vulnerability (median 40 days) when compared to those with lower social vulnerability (median 22 – 27 days). When examining specific treatments received, patients with lower social vulnerability were more likely to experience shorter times to chemotherapy (median 29.5–32 days) when compared to patients with higher social vulnerability (median 41 – 45 days). Patients with the highest social vulnerability experienced the longest time to surgery (median 128 days) amongst all quartiles. There was a trend towards shorter times from diagnosis to palliative care consultation for patients of higher social vulnerability.

Conclusions

Higher social vulnerability was associated with longer times to curative treatment and shorter times to palliative care consultation among ovarian cancer patients. Further study in more diverse patient populations is necessary to ensure the equitable delivery of care in ovarian cancer.