Inequalities in ovarian cancer treatment revealed in new study

Significant inequalities in the treatment of women with ovarian cancer in England have been revealed in a study funded by Yorkshire Cancer Research and led by researchers at Hull York Medical School.

The research, published in Cancer Epidemiology, found that women living in the most disadvantaged areas of the country were 32% less likely to receive surgery and chemotherapy compared to those from more affluent areas. 

Surgery and chemotherapy are the main treatments used in the care of people with ovarian cancer, and those who receive them are more likely to survive.

Ben Pickwell-Smith, Honorary Research Fellow at Hull York Medical School said: “The fact that women from the most deprived backgrounds are significantly less likely to have these treatments suggests that financial or social situation plays a major role in access to life-saving care. Understanding why these disparities exist and, crucially, how to address them, is essential to improving survival for all women with ovarian cancer.”

In the most comprehensive study of its kind, experts examined nearly every woman diagnosed with ovarian cancer in England during 2016 and 2017.

In total, 9572 people were included, with the study utilising high-quality data from NHS England and linking multiple healthcare records to create a detailed picture of each patient’s journey.

According to the findings, women from disadvantaged areas also experienced longer delays in diagnosis and treatment. Although on this occasion these delays were found to be minor and unlikely to impact survival, the research highlights disparities in equitable access to early diagnosis and timely treatment, which is usually linked to enhanced survival rates and improved patient experiences.

The study found that differences in care were also influenced by factors such as age, cancer stage, and other health conditions. Women from more disadvantaged areas faced a greater number of health problems, which impacted their chances of receiving treatment. However, even without these factors, inequalities remained.

Dr Pickwell-Smith said: “Future efforts should concentrate on minimising delays in diagnosis and ensuring that all women, irrespective of their background, have equal access to the best possible treatment."

Ovarian cancer is one of the leading causes of cancer-related death among women worldwide, and survival rates in the UK lag behind those in countries such as Norway, Australia, and Denmark.

In Yorkshire, 573 women are diagnosed with ovarian cancer each year, and 63% of cases are found at a late stage when treatment options are more limited.

People living in Yorkshire are disproportionately affected by health inequalities associated with deprivation. Yorkshire is one of the most deprived regions in England, with 8 of its 13 local authority areas falling within the 20% most deprived local authority areas in the country.

Dr Stuart Griffiths, Director of Research at Yorkshire Cancer Research said: “Sadly, people are more likely to have their lives cut short by cancer in Yorkshire than almost anywhere else in England. As Yorkshire’s cancer charity, Yorkshire Cancer Research is dedicated to changing this so that everyone can live longer, health lives, free from cancer.  

“This research is vital in aiding our understanding of how women from disadvantaged backgrounds are affected by differences in treatment and care. It is clear that where a person lives can unfairly affect their likelihood of surviving cancer.”

The study was completed as part of the TRANSFORMing Cancer Outcomes in Yorkshire programme led by Professor Una Macleod at Hull York Medical School and funded by Yorkshire Cancer Research. The £4.9m programme aims to understand why differences exist in cancer diagnosis and survival in Hull and Yorkshire, and how to reduce inequalities, speed up referrals and improve access to care and treatment.