PROJECT SUMMARY / ABSTRACT
Invasive epithelial ovarian cancer accounts for 5% of malignancies and, while it is the eighth most common
cancer in US women, it is the fifth leading cause of cancer deaths. Many of the established and suspected risk
factors for ovarian cancer show racial differences in the prevalence and/or timing of exposures. Racial
differences in incidence and survival are likely due to a combination of factors, including differences in the
prevalence of risk factors, treatment received, prevalence of comorbidities, and socioeconomic characteristics.
The newly-formed consortium, Ovarian Cancer in Women of African Ancestry (OCWAA), brings together
investigators experienced in studying the epidemiology of ovarian cancer and dedicated to understanding
racial differences in risk and outcomes in ovarian cancer. The OCWAA consortium includes an ongoing
population-based case-control study in African American (AA) women, three completed population-based
case-control studies that include both AA and white cases and controls and two unique cohort studies with
large numbers of AA participants. To address racial differences in incidence and survival, we will
comprehensively examine reproductive and lifestyle exposures which differ in prevalence and/or timing
between AA and white women, access to care, treatment and socioeconomic factors, and determine whether
they explain racial disparities. We propose to harmonize risk factor, clinical and outcome data from the
participating studies in the OCWAA consortium in order to accomplish the study goals and carry out race-
specific analyses of incidence and survival. We will use traditional methods to calculate population attributable
risk percent (PAR%) for associated risk factors. We will use a novel and exploratory approach, a Markov
state-transition microsimulation model, to estimate the extent to which racial differences in patterns of
exposure to known risk factors explain racial differences in ovarian cancer age-specific incidence and use this
same method to estimate the extent to which racial differences in patterns of exposure, treatment, and
prognostic factors explain racial differences in ovarian cancer survival. The proposed study will be the largest
of its kind and the first to be adequately powered to evaluate epidemiologic and clinical factors affecting
incidence and survival of ovarian cancer in AA women. The infrastructure generated by this application will
enable OCWAA to create a base on which to support future scientific proposals.
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