A University of North Carolina at Chapel Hill (UNC) research team has received a two-year, $500,000 grant from the Centers for Disease Control and Prevention (CDC) to better understand healthcare-related factors that predict earlier diagnoses of ovarian cancer in North Carolinians, particularly among women of color, lower income, and rural populations. The study will be the first in the U.S. to examine pathways and timeliness of ovarian cancer diagnosis.
“There is no test for ovarian cancer in asymptomatic patients, and, despite important advances in treatment, many women are diagnosed at later stages when the cancer has already spread throughout the body. It’s important to better understand the early warning signs and factors that may predispose women to ovarian cancer so that providers can diagnose ovarian cancers earlier, when they are more amenable to treatment,” said Caroline A. Thompson, PhD, the study’s principal investigator. Thompson is a research fellow for the UNC Center for Health Promotion and Disease Prevention (HPDP), an associate professor of epidemiology in the UNC Gillings School of Global Public Health and member of the UNC Lineberger Comprehensive Cancer Center.
While ovarian cancer accounts for only 3% of all cancers, it is the fifth-leading cause of cancer-related death among U.S. women. Further, risk of death from ovarian cancer is higher for Black women in the U.S., as well as women whose socioeconomic status or rural location limit their access to cancer care.
Past scholarship has found these outcome disparities are not fully explained by inequitable treatment—Black, rural, and low-income patients are more likely to be diagnosed with ovarian cancer at a higher stage and with more advanced symptoms, already reducing their likelihood for survival.
“Understanding how to intervene earlier is essential to reducing these survival disparities in medically and socially vulnerable populations. Recognizing symptoms early, linking people to appropriate, well-coordinated care, and offering support resources like navigation and transportation assistance may be vital to timely diagnosis and follow-up in these populations,” said Stephanie Wheeler, PhD, a co-investigator of the study who is a research fellow at HPDP, professor at the UNC Gillings School of Global Public Health, and associate director of community outreach and engagement at the UNC Lineberger Comprehensive Cancer Center.
The study will examine data from UNC Health ovarian cancer patients who were diagnosed at all stages and in various health care settings (primary care, secondary care, and emergency care). Thompson and her team hope to learn why some ovarian cancer patients are diagnosed at much earlier stages than others. From those results, the researchers will develop best practices for ovarian cancer screening and diagnosis, including improved public health messaging, enhanced screening and diagnostic tools for primary care providers, and strategies for minimizing delays to diagnosis.
Thompson’s team at UNC will collaborate with researchers at the University of California San Francisco (UCSF) who will investigate a similar set of questions in a patient population from Northern California and contribute to a meta-analysis combining results from both the North Carolina and California studies.
“Our collaboration with UCSF is particularly exciting due to the richness of their data and our combined abilities to identify disparities across a range of geographies and patient groups, including women who identify as African American or Black, Hispanic, Asian American, and Pacific Islander, in a way that better generalizes to the rich diversity of the U.S.,” said Thompson.
This study was funded as a CDC Special Interest Project (SIP), which supports public health prevention research strategies. HPDP is one of 26 CDC Prevention Research Centers in the U.S. eligible to apply for SIP grants.
“A core component of HPDP’s mission is to collaborate with research partners to improve health equity, prevent disease, and enhance knowledge among health care practitioners. I believe this study will accomplish all of those goals and more,” said Alice Ammerman, DrPH, HPDP director.
The study begins September 30, 2022. Results and action plans will be shared with health care providers, community members, and the CDC.
The UNC Center for Health Promotion and Disease Prevention addresses pressing health problems by collaborating with communities to conduct research, provide training, and translate research findings into policy and practice. The Center seeks to reduce health disparities through an emphasis on community-engaged research.