# Association of social vulnerability with access to treatment in ovarian cancer patients

## TL;DR

This study finds that ovarian cancer patients with higher social vulnerability face longer delays in curative treatment and shorter times to palliative care, highlighting disparities in cancer care access.

## Contribution

This is the first study to examine treatment access in ovarian cancer patients based on social vulnerability.

## Key findings

- Patients with high social vulnerability had longer times to curative treatment and shorter times to palliative care.
- Higher social vulnerability was associated with delayed chemotherapy and surgery initiation.
- Social vulnerability may help evaluate a patient’s risk of treatment delay.

## Abstract

•Ovarian cancer patients with higher social vulnerability may have worse oncologic outcomes, including decreased survival.•This is the first study to examine access to treatment in ovarian cancer patients according to social vulnerability.•Patients with high social vulnerability experience longer times to curative treatment and shorter times to palliative care.•Social vulnerability may serve as a valuable tool for holistically evaluating a patient’s risk of delay.

Ovarian cancer patients with higher social vulnerability may have worse oncologic outcomes, including decreased survival.

This is the first study to examine access to treatment in ovarian cancer patients according to social vulnerability.

Patients with high social vulnerability experience longer times to curative treatment and shorter times to palliative care.

Social vulnerability may serve as a valuable tool for holistically evaluating a patient’s risk of delay.

To understand disparities in access to treatment for ovarian cancer patients.

A retrospective review of patients who had surgery for ovarian cancer at a comprehensive cancer center from 2018 to 2024 was completed. Social Vulnerability index quartiles generated by patients’ zip codes were used as measures of social vulnerability. Social vulnerability encompasses four themes, including socioeconomic status, household characteristics, racial/ethnic minority status, and housing type and transportation. The primary outcome was time to treatment initiation. Secondary outcomes included time to chemotherapy, time to surgery, time to palliative care treatment, and progression-free survival. Logistic regression was used to assess the relationship between social vulnerability and treatment access.

Among 166 ovarian cancer patients, there was a trend towards increased time from diagnosis to treatment amongst patients with the highest social vulnerability (median 40 days) when compared to those with lower social vulnerability (median 22 – 27 days). When examining specific treatments received, patients with lower social vulnerability were more likely to experience shorter times to chemotherapy (median 29.5–32 days) when compared to patients with higher social vulnerability (median 41 – 45 days). Patients with the highest social vulnerability experienced the longest time to surgery (median 128 days) amongst all quartiles. There was a trend towards shorter times from diagnosis to palliative care consultation for patients of higher social vulnerability.

Higher social vulnerability was associated with longer times to curative treatment and shorter times to palliative care consultation among ovarian cancer patients. Further study in more diverse patient populations is necessary to ensure the equitable delivery of care in ovarian cancer.