Title : A scoping review of barriers of care to ovarian cancer
Abstract:
Background: Ovarian cancer remains a serious issue in the United States, with ovarian cancer being a leading cause of female cancer-related deaths, thus making it the most lethal female genital tract cancer. However, patients are being diagnosed late and subjected to disease progression and possible death due to lack of early detection. Previous analysis and research suggest that early stage detection of ovarian cancer could improve survival rates as much as 30%. Early detection and access to care are closely related. However, many barriers to high-quality care exist for patients and a majority of patients do not receive recommended care according to ovarian cancer treatment guidelines. In order to improve care for ovarian cancer patients and decrease healthcare disparities in accessing equitable care, it is important to acknowledge the current gaps in patient knowledge, healthcare availability, and physician practice.
Objective: This scoping review explores the available evidence on ovarian cancer to identify these barriers to care in the effective treatment of ovarian cancer.
Methods: A comprehensive electronic search was conducted to identify articles discussing socioeconomic, racial, and demographic factors as barriers to ovarian cancer. The studies used in this scoping review were found through searches in PubMed, Medline, CINAHL Complete, Cochrane Database of Systematic Reviews, and Biomedical Reference Collection: Comprehensive. The following inclusion criteria were used: (1) articles published between 2002 and 2021, (2) full texts in English, (3) articles discussing socioeconomic, racial, and demographic factors as barriers to ovarian cancer, and (4) articles about barriers to care before diagnosis.
Results: Less than half of women diagnosed with ovarian cancer receive the recommended care due to factors such as low SES, low volume surgeons and hospitals, race, lack of insurance, and non-English fluency. Only a small percentage of the patients were aware that genetic testing was available, with worse numbers in African Americans and those with lower education levels. Nearly half of high-risk women were not provided with written resources about risk-reducing bilateral salpingo-oophorectomy (RRBSCO), and in many cases there was no clear pathway to standardize who should receive additional referrals to other specialists. Another large barrier was the availability of appropriate ovarian cancer providers and patient access to these providers. The findings of this review will give physicians and patients better insight into what barriers may exist and how they may be curtailed for more efficient ovarian cancer management.
Audience Take Away:
• The aim of this study and presentation is to ensure that both patients and their physicians are aware of all treatment options for ovarian cancer, as well as to acknowledge barriers to guideline care with the goal of reducing these barriers in the future.
• The audience will learn of the barriers to care that were identified in this study, such as low SES, low volume surgeons and hospitals, race, lack of insurance, and non-English fluency.
• The audience will be able to better advocate for themselves as patients and have a better understanding of treatment options as healthcare providers.
