Table 3.
Odds of Obtaining Care from Gynecologist Oncologists Overall and by Phase of Cancer, SEER-Medicare Linked Data 2000–2006
| Phase of Cancer Care | ||||
|---|---|---|---|---|
| Overall | Initial | Continuing | Final | |
| Variable (Reference) | OR (95% CI) N = 4,181 | OR (95% CI) N = 2,159 | OR (95% CI) N = 1,616 | OR (95% CI) N = 3,511 |
| Race/ethnicity (non-Hispanic white) | ||||
| Non-Hispanic African American | 1.09 (0.82, 1.46) | 0.94 (0.61–1.45) | 1.00 (0.59, 1.69) | 1.16 (0.84, 1.60) |
| Hispanic of any race | 1.02 (0.73, 1.43) | 0.97 (0.61–1.54) | 1.07 (0.62–1.82) | 1.26 (0.87, 1.84) |
| Non-Hispanic Asian | 0.95 (0.62, 1.45) | 0.70 (0.39–1.26) | 0.55 (0.28, 1.11) | 1.06 (0.65, 1.71) |
| Predisposing factors | ||||
| Age at diagnosis (66–69) | ||||
| 70–74 | 1.00 (0.81, 1.23) | 0.94 (0.73, 1.21) | 1.05 (0.79, 1.39) | 1.04 (0.82, 1.33) |
| 75–79 | 0.69 (0.56, 0.85)* | 0.79 (0.60, 1.03) | 0.77 (0.57, 1.04) | 0.68 (0.53, 0.86)* |
| 80–84 | 0.42 (0.33, 0.52)* | 0.64 (0.47, 0.87)* | 0.59 (0.41, 0.86)* | 0.45 (0.35, 0.59)* |
| ≥85 | 0.22 (0.17, 0.29)* | 0.46 (0.31, 0.69)* | 0.43 (0.26, 0.74)* | 0.29 (0.22, 0.40)* |
| Marital status (unmarried) | ||||
| Married | 1.34 (1.16, 1.55)* | 1.09 (0.90, 1.31) | 1.15 (0.92, 1.43) | 1.35 (1.14, 1.60)* |
| English-speaking status (English speaking) | ||||
| Lower English-speaking census tract | 0.94 (0.79, 1.12) | 0.90 (0.71, 1.14) | 1.01 (0.77, 1.33) | 1.04 (0.85, 1.27) |
| Education (higher education) | ||||
| Lower education census tract | 0.86 (0.71, 1.04) | 1.03 (0.80, 1.32) | 1.05 (0.78, 1.41) | 0.81 (0.65, 1.00)* |
| Need factors | ||||
| Stage of cancer (I) | ||||
| II | 0.99 (0.71, 1.38) | 1.04 (0.71, 1.53) | 1.31 (0.85, 2.01) | 0.96 (0.59, 1.58) |
| III | 1.23 (0.98, 1.56) | 1.43 (1.10, 1.87)* | 1.39 (1.03, 1.88)* | 1.60 (1.12, 2.28)* |
| IV | 0.57 (0.45, 0.72)* | 0.75 (0.56, 1.01) | 0.87 (0.61, 1.23) | 0.98 (0.68, 1.40) |
| Unstaged | 0.35 (0.26, 0.46)* | 0.46 (0.31, 0.69)* | 0.67 (0.42, 1.07) | 0.61 (0.40, 0.92)* |
| Comorbidities (0) | ||||
| 1–2 | 1.12 (0.96, 1.31) | 1.21 (0.99, 1.48) | 1.03 (0.82, 1.29) | 1.05 (0.88, 1.26) |
| >2 | 0.82 (0.68, 0.995)* | 1.02 (0.78, 1.35) | 0.82 (0.59, 1.14) | 0.87 (0.70, 1.09) |
| Enabling factors | ||||
| Income (lower income) | ||||
| Higher income census tract | 1.19 (1.01, 1.42)* | 1.44 (1.15, 1.80)* | 1.44 (1.11, 1.87)* | 1.21 (0.99, 1.47) |
| Region (urban) | ||||
| Rural | 0.74 (0.56, 0.97)* | 0.75 (0.52, 1.07) | 0.75 (0.48, 1.18) | 0.78 (0.57, 1.07) |
| SEER registry (Atlanta) | ||||
| San Francisco | 1.02 (0.58, 1.78) | 0.83 (0.38, 1.80) | 0.40 (0.18, 0.90)* | 0.93 (0.50, 1.75) |
| Connecticut | 1.09 (0.67, 1.79) | 0.85 (0.44, 1.64) | 1.28 (0.63, 2.59) | 1.27 (0.73, 2.20) |
| Detroit | 0.36 (0.23, 0.59)* | 0.14 (0.07, 0.28)* | 0.35 (0.17, 0.70)* | 0.66 (0.39, 1.14) |
| Iowa | 0.53 (0.32, 0.89)* | 0.36 (0.18, 0.70)* | 0.43 (0.20, 0.91)* | 0.60 (0.33, 1.08) |
| New Mexico | 2.55 (1.30, 4.99)* | 1.65 (0.63, 4.32) | 2.78 (0.88, 8.74) | 2.02 (1.01, 4.02)* |
| Seattle | 0.59 (0.36, 0.96)* | 0.39 (0.20, 0.74)* | 0.24 (0.11, 0.49)* | 0.63 (0.36, 1.10) |
| Utah | 0.19 (0.10, 0.35)* | 0.14 (0.07, 0.31)* | 0.11 (0.04, 0.32)* | 0.24 (0.11, 0.51)* |
| San Jose | 0.95 (0.51, 1.79) | 0.82 (0.36, 1.88) | 0.35 (0.15, 0.83)* | 0.45 (0.21, 0.98)* |
| Los Angeles | 0.77 (0.47, 1.25) | 0.55 (0.29, 1.04) | 0.71 (0.35, 1.41) | 0.86 (0.50, 1.49) |
| Greater California | 0.42 (0.27, 0.65)* | 0.34 (0.19, 0.60)* | 0.38 (0.20, 0.70)* | 0.41 (0.25, 0.67)* |
| Kentucky | 0.97 (0.59, 1.57) | 0.87 (0.45, 1.68) | 1.06 (0.52, 2.16) | 1.18 (0.68, 2.06) |
| Louisiana | 0.43 (0.27, 0.70)* | 0.29 (0.15, 0.54)* | 0.37 (0.18, 0.76)* | 0.56 (0.33, 0.97)* |
| New Jersey | 0.94 (0.61, 1.45) | 0.57 (0.32, 1.02) | 0.62 (0.35, 1.21) | 1.01 (0.62, 1.65) |
| Other | 1.14 (0.64, 2.02) | 1.23 (0.54, 2.83) | 2.42 (0.94, 6.24) | 1.18 (0.63, 2.23) |
| Observation not used | 52 | 21 | 15 | 49 |
*
Significant at p ≤ .05.