Where women live may influence ovarian cancer survival, especially among Black women – study

Women living in socially vulnerable neighbourhoods had a 20 per cent higher risk of death after an ovarian cancer diagnosis, a study found.

Black women also faced a 45 per cent higher risk of death than white women.

Researchers said the combination of being Black and living in a highly vulnerable neighbourhood was linked to a greater risk of death than would be expected from either factor alone.

Francesmary Modugno, professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh and senior author, said: “We expected residential context to influence outcomes, but what surprised us was how much stronger the impact was for Black women.

“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.”

Modugno is part of the Women’s Cancer Research Center, a collaboration between UPMC Hillman Cancer Center and Magee-Womens Research Institute.

Epithelial ovarian cancer is the deadliest form of gynaecological cancer, with around half of patients surviving for five years after diagnosis.

Survival is lower among Black women, with fewer than 40 per cent alive five years after diagnosis.

Differences including age at diagnosis, cancer stage and tumour type explain some of the survival gap, but researchers said a substantial proportion remains unexplained.

Researchers examined whether social determinants of health, including conditions in the communities where patients live, could help explain the remaining difference in outcomes.

The study, carried out 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 Center.

The group included 509 Black women and 2,035 white women.

Researchers linked patients’ residential census tracts to the US Centers for Disease Control and Prevention’s Social Vulnerability Index.

The index measures neighbourhood factors including poverty, housing conditions, transport access, educational attainment and other socioeconomic challenges.

Black women in the study were more likely to live in highly vulnerable neighbourhoods.

However, where women lived did not fully explain the racial difference in survival.

Black women had poorer survival than white women even when they lived in similarly advantaged communities, while being Black and living in a highly vulnerable neighbourhood together was associated with a greater risk of death than expected from either factor alone.

Researchers said the findings could help health systems and cancer services identify women at greater risk and provide additional support.

Possible measures include patient navigation programmes, transport assistance, childcare support and survivorship services to help patients complete treatment and manage the challenges of cancer care.

Rebecca Arend, associate professor of gynaecology oncology at the University of Alabama at Birmingham, said: “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.”

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

The study builds on research published in 2025 led by Modugno and University of Pittsburgh colleagues using data from UPMC Hillman Cancer Center in western Pennsylvania.

That research also found an association between social vulnerability and ovarian cancer survival.

The latest analysis included a substantially larger group of Black women and examined more closely how residential conditions might contribute to racial inequalities in outcomes.

Researchers said the findings need to be replicated in other parts of the US and among additional racial and ethnic groups to determine how widely they apply.

Future work will examine other social and environmental factors that could affect ovarian cancer survival, including neighbourhood pollution, access to food and community resources.

Researchers hope the findings could lead health systems to develop more targeted support for patients at greatest risk of poor outcomes.

Adding neighbourhood measures such as the Social Vulnerability Index to cancer care planning could help health systems identify women facing barriers to care and connect them with support during treatment.