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Showing content from https://pubmed.ncbi.nlm.nih.gov/30003341/ below:

Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

. 2019 Feb;27(2):531-538. doi: 10.1007/s00520-018-4340-9. Epub 2018 Jul 12. Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Affiliations

¹ National Cancer Institute, Bethesda, MD, USA.
² George Washington University School of Nursing, Washington, DC, USA.
³ Roswell Park Cancer Institute, Buffalo, NY, USA.
⁴ University of California, Irvine, CA, USA.
⁵ Massey Cancer Center, Richmond, VA, USA. sarah.temkin@vcuhealth.org.

PMID: 30003341
PMCID: PMC6330149
DOI: 10.1007/s00520-018-4340-9

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Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Jennifer L Moss et al. Support Care Cancer. 2019 Feb.

. 2019 Feb;27(2):531-538. doi: 10.1007/s00520-018-4340-9. Epub 2018 Jul 12. Affiliations

¹ National Cancer Institute, Bethesda, MD, USA.
² George Washington University School of Nursing, Washington, DC, USA.
³ Roswell Park Cancer Institute, Buffalo, NY, USA.
⁴ University of California, Irvine, CA, USA.
⁵ Massey Cancer Center, Richmond, VA, USA. sarah.temkin@vcuhealth.org.

PMID: 30003341
PMCID: PMC6330149
DOI: 10.1007/s00520-018-4340-9

Item in Clipboard

Abstract

Purpose: Social determinants may influence health-related quality of life (HRQOL) among women with ovarian cancer, potentially creating disparities in clinical outcomes. We investigated the relationship between HRQOL and social determinants of health, including travel distance to access cancer care and health insurance type, among women participating in a randomized trial of primary adjuvant treatment for advanced ovarian cancer.

Methods: The Functional Assessment of Cancer Therapy-Ovarian (FACT-O) questionnaire captured HRQOL (physical well-being, functional well-being, ovarian-specific, and trial outcome index [TOI]) prior to chemotherapy (baseline), during the trial, and 84 weeks after initiation of chemotherapy for women with advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer. We constructed bivariate and multivariable linear mixed effects models examining the associations of social determinants of health (individual-level and contextual factors) with HRQOL scores at 84 weeks, clustering participants (n = 993) within treatment centers, and Census regions and controlling for baseline HRQOL.

Results: Most individual-level (race, age, cancer stage, adverse events) and contextual (travel distance to treatment center, community socioeconomic status) factors were not statistically significantly associated with HRQOL. Compared to participants with private health insurance, other participants had lower mean HRQOL (physical well-being: public insurance, - 1.00 (standard error[SE] = 0.49) points, uninsured, - 1.93 (SE = 0.63) points; functional well-being: public, - 1.29 (SE = 0.59), uninsured, - 1.98 (SE = 0.76); ovarian cancer-specific: public, - 1.60 (SE = 0.59), uninsured, - 1.66 (SE = 0.75); TOI: public, - 3.81 (SE = 1.46), uninsured, - 5.51 (SE = 1.86); all p < .05).

Conclusions: Private health insurance was associated with improved HRQOL at the completion of treatment for advanced stage ovarian cancer. Implications of health insurance on HRQOL should be further investigated, particularly among women with ovarian cancer who receive standard of care treatment.

Keywords: Community health; Health insurance; Health-related quality of life; Ovarian cancer; Social determinants of health; Travel distance.

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Conflict of interest statement

Conflict of Interest Statement

This manuscript was prepared or accomplished by the authors in their personal capacity. The opinions expressed in this article are the authors’ own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. The statements presented in this publication are solely the responsibility of the author(s) and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors, or its Methodology Committee. None of the authors have conflicts of interest to report. Original data are maintained by NRG Oncology; de-identified data will be made available to the journal for review if requested.