Grant Number:	5R37CA233777-08 Interpret this number
Primary Investigator:	Akinyemiju, Tomi
Organization:	Duke University
Project Title:	A Role of Multilevel Healthcare Access Dimensions in Ovarian Cancer Disparities
Fiscal Year:	2025

Ovarian cancer accounts for more deaths than any other cancer of the female reproductive system. In 2021, there were 21,410 new cases of OC and 13,770 deaths. Remarkable progress has been made in ovarian cancer treatment, resulting in a 33% decline in mortality in the past few decades; unfortunately, equitable access to these therapies remains a challenge. While survival rates improved from 40% to 47% among non- Hispanic (NH) White women, survival has stagnated at 35% for NH-Black women. A well-established predictor of the ovarian cancer survival disparity is lack of access to quality treatment. In analysis of the SEER-Medicare database between 2008-2015, only 14% of NH-Black ovarian cancer patients received guideline-concordant surgery and full cycles of recommended chemotherapy, contributing to poor survival. There is also growing recognition of the enduring impact of societal stressors on health outcomes. Yet only a handful of studies have examined these factors in relation to OC disparities, and none have evaluated its contribution via healthcare access (HCA) domains, or via pathways that involve chronic stress associated with discrimination. In this R37 extension, we propose to build on the well-established ORCHiD (Ovarian Cancer Epidemiology, Healthcare Access and Disparities) research infrastructure to examine longitudinal trajectories of HCA and investigate the individual and joint associations of societal stressors with HCA domains and ovarian cancer treatment and survival outcomes in diverse patients. Our proposed extension substantially moves us towards translational impact by addressing key gaps in the literature regarding the mechanisms through which healthcare access domains impact OC disparities.




Vaginal Microbiome Composition, Diversity and Dysbiosis: The ORCHiD Study.
Authors: Deveaux A. , Osazuwa-Peters O. , Kim Y.J. , Shi P. , Neish D. , Joshi A. , Duck V. , Williams A. , Kuliszewski M.G. , Huang B. , et al. .
Source: Research Square, 2025-09-11 00:00:00.0; , .
EPub date: 2025-09-11 00:00:00.0.
PMID: 40964039
Related Citations

Health care access domains and treatment as mediators of ovarian cancer racial disparities in survival: a structural equation modeling analysis in SEER-Medicare.
Authors: Meernik C. , Chen Q. , Wilson L.E. , Joshi A. , Rahman F. , Pisu M. , Liang M. , Ward K.C. , Kuliszewski M.G. , Tucker T. , et al. .
Source: American Journal Of Epidemiology, 2025-08-05 00:00:00.0; 194(8), p. 2230-2240.
PMID: 39479786
Related Citations

Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data.
Authors: Rahman F. , Osazuwa-Peters O.L. , Meernik C. , Ward K.C. , Kuliszewski M.G. , Huang B. , Berchuck A. , Tucker T. , Pisu M. , Liang M. , et al. .
Source: Ssm. Mental Health, 2024 Dec; 6, .
EPub date: 2024-05-24 00:00:00.0.
PMID: 40726731
Related Citations

Frailty in patients with ovarian cancer and the role of healthcare access, race, and ethnicity.
Authors: Meernik C. , Osazuwa-Peters O.L. , Wilson L.E. , Joshi A. , Pisu M. , Liang M.I. , Ward K.C. , Kuliszewski M.G. , Tucker T. , Berchuck A. , et al. .
Source: Gynecologic Oncology, 2024 Nov; 190, p. 146-152.
EPub date: 2024-08-29 00:00:00.0.
PMID: 39213779
Related Citations

Racial Differences in Vaginal Fluid Metabolites and Association with Systemic Inflammation Markers among Ovarian Cancer Patients: A Pilot Study.
Authors: Osazuwa-Peters O.L. , Deveaux A. , Muehlbauer M.J. , Ilkayeva O. , Bain J.R. , Keku T. , Berchuck A. , Huang B. , Ward K. , Gates Kuliszewski M. , et al. .
Source: Cancers, 2024-03-23 00:00:00.0; 16(7), .
EPub date: 2024-03-23 00:00:00.0.
PMID: 38610937
Related Citations

Healthcare Access Dimensions and Racial Disparities in End-of-Life Care Quality among Ovarian Cancer Patients.
Authors: Karanth S. , Osazuwa-Peters O.L. , Wilson L.E. , Previs R.A. , Rahman F. , Huang B. , Pisu M. , Liang M. , Ward K.C. , Schymura M.J. , et al. .
Source: Cancer Research Communications, 2024-03-05 00:00:00.0; 4(3), p. 811-21.
EPub date: 2024-03-05 00:00:00.0.
PMID: 38441644
Related Citations

The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study.
Authors: Karanth S.D. , Akinyemiju T. , Walker C.J. , Yang D. , Migliorati C.A. , Yoon H.S. , Hong Y.R. , Washington C.J. , Lattimore C. , Fredenburg K.M. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2023-04-03 00:00:00.0; 32(4), p. 516-523.
PMID: 36780193
Related Citations

Health-care access dimensions and ovarian cancer survival: SEER-Medicare analysis of the ORCHiD study.
Authors: Montes de Oca M.K. , Chen Q. , Howell E. , Wilson L.E. , Meernik C. , Previs R.A. , Huang B. , Pisu M. , Liang M.I. , Ward K.C. , et al. .
Source: Jnci Cancer Spectrum, 2023-03-01 00:00:00.0; 7(2), .
PMID: 36794910
Related Citations

Factor Analysis of Health Care Access With Ovarian Cancer Surgery and Gynecologic Oncologist Consultation.
Authors: Gupta A. , Chen Q. , Wilson L.E. , Huang B. , Pisu M. , Liang M. , Previs R.A. , Moss H.A. , Ward K.C. , Schymura M.J. , et al. .
Source: Jama Network Open, 2023-02-01 00:00:00.0; 6(2), p. e2254595.
EPub date: 2023-02-01 00:00:00.0.
PMID: 36723938
Related Citations

Healthcare Access Domains Mediate Racial Disparities in Ovarian Cancer Treatment Quality in a US Patient Cohort: A Structural Equation Modelling Analysis.
Authors: Akinyemiju T. , Chen Q. , Wilson L.E. , Previs R.A. , Joshi A. , Liang M. , Pisu M. , Ward K.C. , Berchuck A. , Schymura M.J. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2023-01-09 00:00:00.0; 32(1), p. 74-81.
PMID: 36306380
Related Citations

Development and Psychometric Evaluation of Healthcare Access Measures among Women with Ovarian Cancer.
Authors: Akinyemiju T. , Joshi A. , Deveaux A. , Wilson L.E. , Chen D. , Meernik C. , Bevel M. , Gathings J. , Fish L. , Barrett N. , et al. .
Source: Cancers, 2022-12-19 00:00:00.0; 14(24), .
EPub date: 2022-12-19 00:00:00.0.
PMID: 36551751
Related Citations

Healthcare Access Dimensions and Guideline-Concordant Ovarian Cancer Treatment: SEER-Medicare Analysis of the ORCHiD Study.
Authors: Montes de Oca M.K. , Wilson L.E. , Previs R.A. , Gupta A. , Joshi A. , Huang B. , Pisu M. , Liang M. , Ward K.C. , Schymura M.J. , et al. .
Source: Journal Of The National Comprehensive Cancer Network : Jnccn, 2022 Nov; 20(11), p. 1255-1266.e11.
PMID: 36351338
Related Citations

Race, Affordability and Utilization of Supportive Care in Ovarian Cancer Patients.
Authors: Anyanwu M.C. , Ohamadike O. , Wilson L.E. , Meernik C. , Huang B. , Pisu M. , Liang M. , Previs R.A. , Joshi A. , Ward K.C. , et al. .
Source: Journal Of Pain And Symptom Management, 2022-09-02 00:00:00.0; , .
EPub date: 2022-09-02 00:00:00.0.
PMID: 36058401
Related Citations

Association of area-level socioeconomic status and non-small cell lung cancer stage by race/ethnicity and health care-level factors: Analysis of the National Cancer Database.
Authors: Gupta A. , Omeogu C.H. , Islam J.Y. , Joshi A.R. , Akinyemiju T.F. .
Source: Cancer, 2022-08-15 00:00:00.0; 128(16), p. 3099-3108.
EPub date: 2022-06-20 00:00:00.0.
PMID: 35719098
Related Citations

Associations of Healthcare Affordability, Availability, and Accessibility with Quality Treatment Metrics in Patients with Ovarian Cancer.
Authors: Akinyemiju T.F. , Wilson L.E. , Diaz N. , Gupta A. , Huang B. , Pisu M. , Deveaux A. , Liang M. , Previs R.A. , Moss H.A. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2022-07-01 00:00:00.0; 31(7), p. 1383-1393.
PMID: 35477150
Related Citations

Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): methodology for a population-based study of black, Hispanic and white patients with ovarian cancer.
Authors: Akinyemiju T. , Deveaux A. , Wilson L. , Gupta A. , Joshi A. , Bevel M. , Omeogu C. , Ohamadike O. , Huang B. , Pisu M. , et al. .
Source: Bmj Open, 2021-10-04 00:00:00.0; 11(10), p. e052808.
EPub date: 2021-10-04 00:00:00.0.
PMID: 34607872
Related Citations

Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States.
Authors: Islam J.Y. , Saraiya V. , Previs R.A. , Akinyemiju T. .
Source: International Journal Of Environmental Research And Public Health, 2021-06-04 00:00:00.0; 18(11), .
EPub date: 2021-06-04 00:00:00.0.
PMID: 34199732
Related Citations

Racial and ethnic disparities in palliative care utilization among gynecological cancer patients.
Authors: Islam J.Y. , Deveaux A. , Previs R.A. , Akinyemiju T. .
Source: Gynecologic Oncology, 2021 02; 160(2), p. 469-476.
EPub date: 2020-12-02 00:00:00.0.
PMID: 33276985
Related Citations

Racial disparities in palliative care utilization among metastatic gynecological cancer patients living at last follow-up: An analysis of the National Cancer Data Base.
Authors: Islam J.Y. , Deveaux A. , Previs R.A. , Akinyemiju T. .
Source: Data In Brief, 2021 Feb; 34, p. 106705.
EPub date: 2020-12-30 00:00:00.0.
PMID: 33473361
Related Citations

Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis.
Authors: Karanth S. , Fowler M.E. , Mao X. , Wilson L.E. , Huang B. , Pisu M. , Potosky A. , Tucker T. , Akinyemiju T. .
Source: Jnci Cancer Spectrum, 2019 Dec; 3(4), p. pkz084.
EPub date: 2019-10-09 00:00:00.0.
PMID: 31840133
Related Citations