Published online May 10, 2014. doi: 10.5317/wjog.v3.i2.71
Revised: December 11, 2013
Accepted: February 16, 2014
Published online: May 10, 2014
AIM: To determine the association between the distribution of gynecologic oncologist (GO) and population-based ovarian cancer death rates.
METHODS: Data on ovarian cancer incidence and mortality in the United States was supplemented with United States census data, and analyzed in relation to practicing GOs. GO locations were geocoded to link association between county variables and GO availability. Logistic regression was used to measure areas of high and low ovarian cancer mortality, adjusting for contextual variables.
RESULTS: Practicing GOs were unevenly distributed in the United States, with the greatest numbers in metropolitan areas. Ovarian cancer incidence and death rates increased as distance to a practicing GO increased. A relatively small number (153) of counties within 24 miles of a GO had high ovarian cancer death rates compared to 577 counties located 50 or more miles away with high ovarian cancer death rates. Counties located 50 or more miles away from a GO practice had an almost 60% greater odds of high ovarian cancer mortality compared to those with closer practicing GOs (OR = 1.59, 95%CI: 1.18-2.15).
CONCLUSION: The distribution of GOs across the United States appears to be significantly associated with ovarian cancer mortality. Efforts that facilitate outreach of GOs to certain populations may increase geographic access.
Core tip: Ovarian cancer death rates increase with increasing distance to practicing gynecologic oncologists in the United States. Lower ovarian cancer mortality is significantly associated with geographic proximity to gynecologic oncologists. A more even geographic distribution of gynecologic oncologists may help in decreasing some barriers to appropriate, guidelines-based ovarian cancer care, which could result in reduced ovarian cancer deaths in the United States.