Abstract
Background: Tubo-ovarian cancer (OC) continues to be the most lethal of all gynaecological cancers. Over half of women are diagnosed with late stage (III/IV) disease, which has a five-year survival rate of 11%. Socioeconomic status (SES) has been shown to have an impact on outcomes of several cancer types, including OC. This study aims to investigate any potential association between SES and stage at diagnosis of OC. Methods: Women from the non-screening arm of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) with a confirmed diagnosis of OC prior to 01 January 2015 and an English index of multiple deprivation (IMD) score were eligible for the study. The association between IMD and OC stage (FIGO) was analysed using an ordinal logistic regression model adjusted for age at diagnosis and BMI. Results: Four-hundred and fifty seven women were eligible for inclusion in the primary analysis. The odds of being diagnosed with the higher dichotomization of stage (I vs. II/III/IV; I/II vs. III/IV; I/II/III vs. IV) was 1.29 (p = 0.017; 95% CI: 1.048–1.592) per unit SD (standard deviation) increase in IMD. This translates to a 29% increase in odds of being diagnosed at the higher stage per each unit SD increase in IMD. Conclusion: Increased deprivation is consistently associated with a higher probability of being diagnosed with later stage OC.
Highlights
Despite advances in treatment over the past three decades, tubo-ovarian cancer (OC) remains the most lethal of all the gynaecological cancers [1]
This suggests that any improvements in detecting the disease at an earlier stage is likely to have an impact on survival [3]
We report on the association between stage at diagnosis of OC and Socioeconomic status (SES) in clinically presenting women in the ‘no screening’ arm of the trial
Summary
Despite advances in treatment over the past three decades, tubo-ovarian cancer (OC) remains the most lethal of all the gynaecological cancers [1]. Most women are diagnosed with late (III-IV) stage disease, which has five-year survival rates of around 11% [2]. Survival for women diagnosed at stage I and II is over 90% and 68%, respectively. This suggests that any improvements in detecting the disease at an earlier stage is likely to have an impact on survival [3]. Over half of women are diagnosed with late stage (III/IV) disease, which has a five-year survival rate of 11%. Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) with a confirmed diagnosis of OC prior to 01 January 2015 and an English index of multiple deprivation (IMD) score were eligible for the study. The odds of being diagnosed with the higher dichotomization of stage (I vs. II/III/IV; I/II vs. III/IV; I/II/III vs. IV) was 1.29
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