Increasing Area Deprivation Index negatively impacts ovarian cancer survival

Demetra H. Hufnagel, Dineo Khabele, Fiona E. Yull, Pamela C. Hull, Joellen Schildkraut, Marta A. Crispens, Alicia Beeghly-Fadiel

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Introduction: While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. Methods: We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. Results: Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. Conclusions: Increasing area-level deprivation may negatively impact ovarian cancer survival.

Original languageEnglish
Article number102013
JournalCancer Epidemiology
StatePublished - Oct 2021

Bibliographical note

Funding Information:
ABF, FEY, and MAC were supported in part by the National Institutes of Health (NIH) National Cancer Institute (NCI) Precision Medicine and Health Disparities Collaborative (PMHDC) Pilot Study U54 MD010722. ABF, MAC, DK, and FEY were supported in part by the NIH NCI grant R01 CA214043. ABF and MAC were also supported in part by the NIH NCI grant U54 CA163072. DHH was also supported in part by a 2018 Burroughs Wellcome Fund Physician-Scientist Institutional Award to Vanderbilt University [ID: 1018894]. These funding sources had no role in study design; collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Publisher Copyright:
© 2021


  • Ovarian neoplasms
  • Prognosis
  • Socioeconomic factors
  • Survival

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Cancer Research


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