Table 2.
Multivariable models of chemotherapy use.
| Covariate | Low Risk 1 | Intermediate Risk | High Risk |
|---|---|---|---|
| Age | |||
| <40 | Referent | Referent | Referent |
| 40–49 | 1.12 (0.92–1.38) | 1.03 (0.89–1.20) | 0.99 (0.95–1.04) |
| 50–59 | 1.22 (1.00–1.49) | 1.10 (0.96–1.27) | 1.04 (1.00–1.09) |
| 60–69 | 1.05 (0.81–1.36) | 0.97 (0.83–1.14) | 1.05 (1.00–1.10) |
| ≥70 | 0.56 (0.39–0.79)* | 0.74 (0.61–0.89)* | 0.84 (0.79–0.90)* |
| Race | |||
| White | Referent | Referent | Referent |
| Black | 0.74 (0.52–1.04) | 0.97 (0.80–1.17) | 0.88 (0.83–0.94)* |
| Hispanic | 0.63 (0.41–0.97)* | 0.95 (0.80–1.13) | 0.98 (0.93–1.04) |
| Other/unknown | 0.94 (0.67–1.32) | 1.10 (0.90–1.34) | 0.96 (0.91–1.02) |
| Insurance | |||
| Private | Referent | Referent | Referent |
| Medicaid | 1.06 (0.77–1.48) | 1.04 (0.86–1.25) | 1.03 (0.97–1.09) |
| Medicare | 0.99 (0.78–1.27) | 0.88 (0.77–1.01) | 0.96 (0.93–1.00) |
| Uninsured | 1.01 (0.75–1.35) | 0.87 (0.73–1.04) | 1.02 (0.97–1.07) |
| Other government/unknown | 1.00 (0.68–1.47) | 0.92 (0.74–1.16) | 0.98 (0.93–1.04) |
| Facility Location | |||
| Eastern | Referent | Referent | Referent |
| Midwest | 0.90 (0.73–1.12) | 1.00 (0.86–1.17) | 0.97 (0.93–1.02) |
| South | 0.95 (0.77–1.18) | 0.97 (0.83–1.14) | 0.94 (0.89–0.99)* |
| West | 0.75 (0.59–0.96)* | 0.84 (0.69–1.02) | 0.88 (0.82–0.94)* |
| Facility Type | |||
| Community cancer | - | Referent | Referent |
| Academic/research | - | 1.11 (0.91–1.35) | 1.06 (0.99–1.12) |
| Comprehensive community cancer | - | 1.06 (0.87–1.29) | 0.96 (0.90–1.03) |
| Other | - | 1.81 (1.49–2.21)* | 0.75 (0.70–0.80)* |
| Urban/Rural | |||
| Metropolitan | Referent | Referent | Referent |
| Urban | 0.91 (0.73–1.13) | 1.05 (0.92–1.20) | 1.03 (0.99–1.06) |
| Rural | 0.79 (0.42–1.49) | 0.85 (0.60–1.19) | 1.04 (0.94–1.14) |
| Unknown | 0.89 (0.63–1.26) | 1.05 (0.87–1.27) | 0.98 (0.93–1.04) |
| Histology | |||
| Serous | Referent | Referent | Referent |
| Mucinous | 0.85 (0.65–1.12) | 0.72 (0.63–0.83)* | 0.90 (0.86–0.94)* |
| Endometrioid | 1.69 (1.33–2.16)* | 1.09 (0.99–1.21) | 1.01 (0.98–1.05) |
| Clear cell | – | – | 1.07 (1.03–1.10)* |
| Transitional cell | – | 2.15 (1.45–3.17)* | 1.00 (0.87–1.14) |
| Epithelial tumor NOS | 1.37 (0.93–2.01) | 0.87 (0.71–1.06) | 0.95 (0.89–1.00) |
| Grade | |||
| 1 | – | – | Referent |
| 2 | – | – | 1.14 (1.09–1.19)* |
| 3 | – | – | 1.18 (1.13–1.23)* |
| Unknown | – | – | 1.00 (0.95–1.06) |
| Stage | |||
| IA | Referent | Referent | Referent |
| IB | 2.43 (2.02–2.91)* | 1.37 (1.23–1.51)* | 1.06 (0.99–1.13) |
| IC | – | – | 1.17 (1.14–1.21)* |
| Lymph nodes examined | |||
| Yes | Referent | Referent | Referent |
| No | 0.98 (0.81–1.17) | 0.95 (0.85–1.06) | 0.93 (0.90–0.96)* |
| Unknown | 1.03 (0.49–2.14) | 0.88 (0.55–1.41) | 1.05 (0.94–1.17) |
| Year of Diagnosis | |||
| 1998 | Referent | Referent | Referent |
| 1999 | 0.75 (0.51–1.10) | 1.00 (0.81–1.24) | 1.02 (0.95–1.09) |
| 2000 | 0.91 (0.64–1.30) | 1.00 (0.80–1.24) | 0.98 (0.91–1.05) |
| 2001 | 0.90 (0.63–1.28) | 0.97 (0.77–1.22) | 1.01 (0.94–1.08) |
| 2002 | 0.88 (0.59–1.29) | 0.90 (0.72–1.13) | 0.99 (0.92–1.06) |
| 2003 | 0.75 (0.49–1.12) | 1.03 (0.84–1.26) | 1.01 (0.94–1.08) |
| 2004 | 0.62 (0.39–0.96)* | 1.07 (0.86–1.33) | 0.95 (0.88–1.02) |
| 2005 | 0.88 (0.60–1.29) | 0.99 (0.80–1.23) | 0.99 (0.92–1.06) |
| 2006 | 0.83 (0.58–1.18) | 1.02 (0.81–1.28) | 0.98 (0.92–1.05) |
| 2007 | 0.83 (0.56–1.23) | 0.90 (0.72–1.14) | 1.02 (0.95–1.09) |
| 2008 | 0.91 (0.63–1.32) | 0.98 (0.78–1.24) | 1.05 (0.99–1.12) |
| 2009 | 0.91 (0.63–1.31) | 0.97 (0.77–1.22) | 1.02 (0.96–1.09) |
| 2010 | 1.06 (0.74–1.52) | 1.08 (0.87–1.33) | 1.06 (1.00–1.14) |
| 2011 | 1.02 (0.72–1.45) | 1.11 (0.90–1.36) | 1.05 (0.98–1.12) |
| 2012 | 0.87 (0.60–1.25) | 1.10 (0.89–1.36) | 1.06 (0.99–1.13) |
Adjusted risk ratio (95% confidence interval).38 patients missing facility identifier were excluded; 4,188, 3,771, and 13,759 patients were analyzed in low, intermediate, and high-risk groups.
P<0.05
Two transitional cell patients were excluded
Generalized estimating equations were fit accounting for facility-level clustering. The covariates included were: low-risk: age, race, insurance status, facility region, facility location, histology, stage, lymph node examination, and year of diagnosis; intermediate-risk: age, race, insurance status, facility region, facility type, facility location, histology, stage, lymph node examination, and year of diagnosis; high-risk: age, race, insurance status, facility region, facility type, facility location, histology, stage, grade, lymph node examination, and year of diagnosis.