Exploring factors related to racial disparities in ovarian cancer incidence and survival: the OCWAA consortium

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.