UC Irvine

ABSTRACT OF THE THESIS

Impact of Race and Ethnicity on Short-term Surgical Outcomes in Women Treated

for Cervical Cancer: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2011-2014

By

Paula M. Gutierrez

Master of Science in Biomedical and Translational Science

University of California, Irvine, 2017

Professor Dr. Robert E. Bristow, Chair

Variations in access to U.S. healthcare have contributed to racial and ethnic disparities in cervical cancer survival and mortality patterns. Evaluation of postoperative complications after cervical cancer surgery in American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals’ remains limited. In this study, we investigate the association between race/ethnicity and 30-day morbidity in women undergoing cervical cancer surgery.

Using ACS-NSQIP database, 1248 patients undergoing surgery in 2011-2014 were identified. In this cohort, 70.6% were non-Hispanic White, 12.8% Black and 16.5% Hispanic. Compared to non-Hispanic White, these minority groups were more likely to have medical comorbidities. In adjusted multivariable models, the odds of any postoperative complication were 50% greater in Black compared to non-Hispanic White (p<0.05), including non-surgical complications (OR=1.55, p<0.05). Hispanic ethnicity was not a predictor of 30-day morbidity (OR=0.76; p>0.05).

While Black patients experienced greater non-surgical adverse outcomes, no disparity was observed for Hispanic patients. Findings suggest that to some extent access to ACS NSQIP hospitals can attenuate disparities in postoperative complications after cervical cancer surgery, but much more work is still required to eliminate racial/ethnic disparities.