A new study led by researchers at the University of Pittsburgh found that women living in socially vulnerable communities face a 20% higher risk of death after an ovarian cancer diagnosis compared with women living in less vulnerable communities.

The study, published today in JAMA Network Open, also discovered that Black women face a 45% higher risk of death than white women.

When coupled, the findings suggest that neighbourhood conditions may help explain persistent racial disparities in ovarian cancer survival.

"We expected residential context to influence outcomes, but what surprised us was how much stronger the impact was for Black women," said Francesmary Modugno, Ph.D., M.S., MPH, professor in the Department of Obstetrics, Gynaecology and Reproductive Sciences at Pitt and senior author of the study.

"Our findings suggest that it's not simply where someone lives. The interaction between a woman's lived experience and her residential environment may be helping drive these persistent disparities," added Modugno who is part of The Women’s Cancer Research Centre (WCRC) is a collaboration between the UPMC Hillman Cancer Centre and Magee-Womens Research Institute (MWRI)

Epithelial ovarian cancer is the deadliest gynaecologic cancer, with only about half of patients surviving five years after diagnosis. Survival is even lower among Black women, with fewer than 40% alive five years later.

While differences in factors such as age at diagnosis, cancer stage and tumour type explain some of that disparity, a substantial survival gap remains unexplained.

Researchers hypothesised that factors beyond biology and clinical care may influence survival and sought to determine whether social determinants of health reflected in the communities where patients live could explain the remaining difference in outcomes.

The study, conducted in collaboration with researchers at the University of Alabama at Birmingham, analysed data from 2,544 women diagnosed with epithelial ovarian cancer and treated at the O'Neal Comprehensive Cancer Centre at the University of Alabama at Birmingham. The study data included 509 Black women and 2,035 white women.

Researchers linked patients' residential census tracts to the Centres for Disease Control and Prevention's Social Vulnerability Index, a measure that incorporates neighbourhood-level factors such as poverty, housing conditions, transportation access, educational attainment and other socioeconomic challenges.

Further analyses showed that Black women were more likely to live in highly vulnerable neighbourhoods. Yet residential context alone did not fully explain the survival disparity.

Black women experienced worse survival than white women even when living in similarly advantaged communities, and the combination of being Black and living in a highly vulnerable neighbourhood was associated with a greater risk of death than would be expected from either factor alone.

The findings point to opportunities for health systems and cancer programmes to identify patients at increased risk and provide additional support services.

Examples include patient navigation programmes, transportation assistance, childcare support, survivorship resources and other interventions that can help patients complete treatment and manage the challenges associated with cancer care.

“Our findings reinforce that we must better understand and address the barriers patients face in their communities and ensure that every woman has equitable access to high-quality care,” said Rebecca Arend, M.D., MSPH, associate professor of gynaecology oncology in the Department of Obstetrics and Gynaecology at the University of Alabama at Birmingham.

“Translating research into meaningful improvements in cancer outcomes is only possible through strong collaborations among academic medical centres, researchers and community partners,” said Arend, who also serves as associate director of clinical research at the O’Neal Comprehensive Cancer Centre.

The study builds on previous research published in 2025 led by Modugno and Pitt colleagues using data from UPMC Hillman Cancer Centre in western Pennsylvania, which found that social vulnerability was associated with ovarian cancer survival.

The new study expands on those findings by including a substantially larger population of Black women and examining how residential context may contribute to racial disparities in outcomes.

The findings will need to be replicated in other regions of the United States and among additional racial and ethnic groups to determine how broadly they apply.

Future studies will also explore other social and environmental factors that may influence ovarian cancer survival, including neighbourhood pollution, food access and community resources.

Ultimately, the researchers hope their findings will lead health systems to develop more targeted approaches to support patients at greatest risk of poor outcomes.

By incorporating neighbourhood-level measures such as the Social Vulnerability Index into cancer care planning, health systems may be able to better identify patients facing barriers to care and connect them with supportive resources during treatment.

Article: Residential Context and Survival Disparities in Black and White Women With Ovarian Cancer

Source: University of Pittsburgh