Disparities in vulvar cancer reported by the national cancer database: Influence of sociodemographic factors

Dana M. Chase, Chun Chieh Lin, Christine D. Craig, Stacey A. Fedewa, Katherine S. Virgo, John H. Farley, Michael Halpern, Bradley J. Monk

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To assess whether there is an association of patient sociodemographic factors with stage at diagnosis, treatment, and overall survival in patients with vulvar cancer in the National Cancer Database. METHODS: This was a retrospective cohort study of patients with primary squamous vulvar carcinoma identified from the National Cancer Database (1998-2004). Multivariate logistic regression was conducted to examine risk factors associated with advanced-stage (stage III or IV) disease at diagnosis. Multivariable Cox regression models were performed to explore risk factors associated with 5-year all-cause mortality. RESULTS: Of 11,153 patients, 42.3% (n=4,713) were diagnosed with stage I disease, 24.6% (n=2,745) stage II, 22.9% (n=2,556) stage III, and 10.2% (n=1,139) stage IV. Advanced stage was significantly associated with older age, nonprivate insurance, and treatment at a lower case volume center (P<.01). Of note, roughly 30% of patients with advanced-stage disease did not receive radiation therapy. Within the advanced stages, age 60 years or older and insurance type were associated with decreased survival (P<.01). In stage III disease, only black race and treatment at a community hospital were associated with a lower risk of death (P<.01). CONCLUSION: Patient sociodemographic and clinical characteristics are significantly associated with vulvar cancer stage presentation, treatment, and survival. Unfortunately, within this disease, surgical approaches and adjuvant radiation do not appear consistent.

Original languageEnglish (US)
Pages (from-to)792-802
Number of pages11
JournalObstetrics and Gynecology
Volume126
Issue number4
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Vulvar Neoplasms
Databases
Neoplasms
Insurance
Survival
Community Hospital
Therapeutics
Proportional Hazards Models
Squamous Cell Carcinoma
Cohort Studies
Radiotherapy
Retrospective Studies
Logistic Models
Radiation
Mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Chase, D. M., Lin, C. C., Craig, C. D., Fedewa, S. A., Virgo, K. S., Farley, J. H., ... Monk, B. J. (2015). Disparities in vulvar cancer reported by the national cancer database: Influence of sociodemographic factors. Obstetrics and Gynecology, 126(4), 792-802. https://doi.org/10.1097/AOG.0000000000001033

Disparities in vulvar cancer reported by the national cancer database : Influence of sociodemographic factors. / Chase, Dana M.; Lin, Chun Chieh; Craig, Christine D.; Fedewa, Stacey A.; Virgo, Katherine S.; Farley, John H.; Halpern, Michael; Monk, Bradley J.

In: Obstetrics and Gynecology, Vol. 126, No. 4, 01.01.2015, p. 792-802.

Research output: Contribution to journalArticle

Chase, Dana M. ; Lin, Chun Chieh ; Craig, Christine D. ; Fedewa, Stacey A. ; Virgo, Katherine S. ; Farley, John H. ; Halpern, Michael ; Monk, Bradley J. / Disparities in vulvar cancer reported by the national cancer database : Influence of sociodemographic factors. In: Obstetrics and Gynecology. 2015 ; Vol. 126, No. 4. pp. 792-802.
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N2 - OBJECTIVE: To assess whether there is an association of patient sociodemographic factors with stage at diagnosis, treatment, and overall survival in patients with vulvar cancer in the National Cancer Database. METHODS: This was a retrospective cohort study of patients with primary squamous vulvar carcinoma identified from the National Cancer Database (1998-2004). Multivariate logistic regression was conducted to examine risk factors associated with advanced-stage (stage III or IV) disease at diagnosis. Multivariable Cox regression models were performed to explore risk factors associated with 5-year all-cause mortality. RESULTS: Of 11,153 patients, 42.3% (n=4,713) were diagnosed with stage I disease, 24.6% (n=2,745) stage II, 22.9% (n=2,556) stage III, and 10.2% (n=1,139) stage IV. Advanced stage was significantly associated with older age, nonprivate insurance, and treatment at a lower case volume center (P<.01). Of note, roughly 30% of patients with advanced-stage disease did not receive radiation therapy. Within the advanced stages, age 60 years or older and insurance type were associated with decreased survival (P<.01). In stage III disease, only black race and treatment at a community hospital were associated with a lower risk of death (P<.01). CONCLUSION: Patient sociodemographic and clinical characteristics are significantly associated with vulvar cancer stage presentation, treatment, and survival. Unfortunately, within this disease, surgical approaches and adjuvant radiation do not appear consistent.

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