Benjamin Albright, MD, MS, Assistant Professor of Gynecologic Oncology and Associate Member at the ºÚÁÏÍø Lineberger Comprehensive Cancer Center’s Cancer Prevention and Control Program, led a study to evaluate the relationship between the distance traveled to and proximity of gynecologic oncologists with the receipt of surgical care and racial disparities in the quality of care for nonmetastatic uterine cancer.
CHAPEL HILL, N.C. – Dr. Benjamin Albright has been published in the American Journal of Obstetrics and Gynecology (AJOG) for his work on a collaborative study examining significant disparities in the surgical treatment of endometrial cancer based on geographic location and race. The paper is a collaboration between Dr. Albright and from the University of North Carolina (ºÚÁÏÍø), along with former colleagues MK (Mary Katherine) Anastasio and Haley Moss from Duke University, where Dr. Albright was a fellow prior to joining ºÚÁÏÍø as faculty in the summer of 2023. The study also involved researchers Sarah Ackroyd, Ya-Chen Tina Shih, and Bumyang Kim, who had previously published on the geographic locations of gynecologic oncologists and generously shared their data for this research.
The study, titled “,” aimed to investigate how factors such as the availability of local gynecologic oncologists and the distance patients must travel for surgery impact the likelihood of receiving minimally invasive surgery (MIS) and lymph node sampling (LND) during surgical staging for endometrial cancer.Â
According to Dr. Benjamin Albright, the team of researchers utilized state surgical data from four states, including North Carolina, to conduct their analysis.
“Our goal was to look at how patients travel for endometrial cancer surgery and how distance from gynecologic oncologists or presence of a local gynecologic oncologist impacts receipt of minimally invasive surgery (MIS; always recommended and a quality metric) and lymph node dissection (LND; often recommended depending on tumor characteristics) with their surgical staging. We were interested in exploring the presence of geographic and racial disparities, and the possibility that racial and geographic disparities may compound. Based on our anecdotal experience in treating patients, we hypothesized that rural Black patients may be disproportionately susceptible to worse outcomes (in comparison to rural White patients and urban/metro Black patients). We used state surgical data from 4 states, including North Carolina, to assess this. We also identified an association of hospital volume of endometrial cancer surgery with the likelihood of MIS and LND, with higher volume hospitals more likely to perform the optimal surgery.”
Key Findings:
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Impact of Local Gynecologic Oncologists:
- Patients residing in counties without a local gynecologic oncologist who did not travel to another county for surgery were less likely to receive MIS and LND.
- Traveling to a different county for surgery increased the likelihood of receiving LND.
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Racial Disparities:
- Black patients were less likely to undergo MIS, even after adjusting for confounding factors.
- Black patients without a local gynecologic oncologist who did not travel for surgery faced significantly higher risks of suboptimal surgery compared to white patients in similar situations.
Dr. Albright noted, “we also saw an impact of hospital volume of endometrial cancer surgery on the likelihood of MIS and LND (higher volume hospitals were more likely to perform the optimal surgery.”