Influence of Distance to Road on Ovarian Cancer Mortality

Abstract

Background/Aim: Each year, approximately 14,000 U.S. women die of ovarian cancer (OC). Evidence suggests that residing in areas with greater community disadvantage and higher exposure to ozone and particulate matter 2.5 is associated with worse OC survival. This study’s objective is to examine the influence of residential distance to roads on OC-specific survival in California.Methods: Cases of incident epithelial OC were identified through the California Cancer Registry between 1996 and 2014, with follow-up obtained through 2016. All cancer stages were included in the analysis. We calculated distance to primary and secondary roads using ArcGIS. Cox proportional hazards models were used to examine the association between distance to roads and OC-specific survival, both as an independent predictor and controlling for race, socioeconomic status (SES), cancer characteristics, quality of care, and treating hospital. Results: A total of 29,844 women were included in the analysis, with 67.4% diagnosed in late stages. Among all women, 50% survived up to 2.9 years. The median distance between women’s residence and a primary or secondary road was 0.93km, ranging from <0.01km to 42.3km. An interquartile range (IQR) increase in log distance from roads was associated with a 2.0% decrease in hazards of mortality (p=0.027). After adjusting for important predictors, including SES and treatment, distance to road remained marginally significant (IQR hazard ratio, 0.98; 95% IQR Confidence Interval, 0.97-1.00). Conclusions: This study suggests that greater distances from major roads may be protective among women in California diagnosed with OC.