卵巢癌的 5 年生存率很差，特别是在非西班牙裔 (NH) 黑人患者中。努力识别功能受限和虚弱高风险的患者可能会改善结果。在这项研究中，我们研究了医疗保健获取 (HCA) 和种族/族裔与卵巢癌患者的虚弱程度之间的关系。我们确定了 2009 年至 2015 年间年龄≥6 5 岁时诊断出患有卵巢癌的西班牙裔、新罕布什尔州黑人和新罕布什尔州白人患者使用 SEER-Medicare。使用对数二项式回归来估计 HCA 与种族/民族与诊断前或诊断后虚弱之间的关联的患病率 (PR) 和 95% 置信区间 (CI)，并根据年龄和合并症进行调整。总共 6041 名患者患有卵巢癌的人包括 91.8% NH 白人、6.6% NH 黑人和 1.7% 西班牙裔。诊断前，14.7% 的患者被定义为虚弱（新罕布什尔州白人：14.3%；新罕布什尔州黑人：17.9%；西班牙裔：20.8%）。诊断后，虚弱患病率增加至 58.8%（新罕布什尔州白人：58.2%；新罕布什尔州黑人：65.2%；西班牙裔：70.2%）。在完全调整的模型中，没有观察到种族/民族与诊断前或诊断后虚弱之间存在统计学上的显着关联。根据患者特征以及医疗保健可及性和可用性进行调整后，较高的医疗保健负担能力与诊断前虚弱患病率降低相关（PR：0.91，95％CI：0.8 5，0.98）。卵巢癌患者虚弱患病率较高诊断后，特别是新罕布什尔州黑人和西班牙裔患者。提高医疗保健负担能力可以预防或帮助管理医疗保险患者的虚弱、改善癌症治疗的接受情况并提高癌症生存率。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Ovarian cancer has poor 5-year survival, particularly among non-Hispanic (NH) Black patients. Efforts to identify patients at high-risk of functional limitations and frailty may improve outcomes. In this study, we examined how healthcare access (HCA) and race/ethnicity relate to frailty among patients with ovarian cancer.We identified Hispanic, NH Black, and NH White patients diagnosed at ages ≥6 5 years with ovarian cancer between 2009 and 2015 using SEER-Medicare. Log-binomial regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between HCA and race/ethnicity with pre- or post-diagnosis frailty, adjusting for age and comorbidities.A total of 6041 patients with ovarian cancer were included, including 91.8% NH White, 6.6% NH Black, and 1.7% Hispanic. Pre-diagnosis, 14.7% of patients were defined as frail (NH White: 14.3%; NH Black: 17.9%; Hispanic: 20.8%). Post-diagnosis, frailty prevalence increased to 58.8% (NH White: 58.2%; NH Black: 65.2%; Hispanic: 70.2%). No statistically significant associations were observed between race/ethnicity and pre- or post-diagnosis frailty in fully adjusted models. After adjustment for patient characteristics and healthcare accessibility and availability, higher healthcare affordability was associated with a decreased prevalence of pre-diagnosis frailty (PR: 0.91, 95% CI: 0.8 5, 0.98).Patients with ovarian cancer have a high prevalence of frailty after diagnosis, particularly NH Black and Hispanic patients. Improving healthcare affordability may prevent or help manage frailty in Medicare patients, improve receipt of cancer treatment, and increase cancer survival.Copyright © 2024 Elsevier Inc. All rights reserved.