The Centers for Disease Control and Prevention (CDC) has selected the Iowa Department of Public Health (IDPH) to be a part of a project called “Implementing Health Systems and Environmental Changes to Improve Ovarian Cancer Care.” Iowa, along with two other states (Michigan and Rhode Island) and one tribal organization (South Puget Intertribal Planning Agency) are participating in the project.

IDPH is partnering with the Iowa Cancer Registry, based in the University of Iowa College of Public Health; the Iowa Cancer Consortium; and the University of Iowa Holden Comprehensive Cancer Center to develop a further understanding of referral patterns in Iowa and inform health systems and environmental changes. Investigators from the University of Iowa are conducting interviews with gynecologic oncologists, obstetrician-gynecologists, medical oncologists, and hospital administrators throughout Iowa to learn more about challenges to ovarian cancer care in Iowa in order to inform future strategies to facilitate standard of care treatment for all Iowans with ovarian cancer.

According to Mary Charlton, associate professor of epidemiology at the UI College of Public Health and associate director of the Iowa Cancer Registry, the registry is examining patterns of care among ovarian cancer patients and determining characteristics of patients who are not getting treatment from gynecologic oncologists. “We’re interviewing ovarian cancer survivors about their experiences and the barriers they face in receiving care,” Charlton says. “We’re also talking with OB-GYNs across the state to learn what might make the referral process to gynecologic oncologists easier for patients.”

Ovarian cancer is the eighth most common cancer among women in the United States, and is the fifth leading cause of cancer deaths among women. It causes more deaths than any other cancer of the female reproductive system. Iowa ranks in the top 10 states in the U.S. for ovarian cancer mortality rates.

There are no effective screening or early detection tools for ovarian cancer. Given the lack of prevention and early detection, effective treatment has emerged as an evidence-based mechanism for reducing ovarian cancer mortality. Consultation and receipt of surgery from a gynecologic oncologist is a well-established and evidence-based guideline constituting standard care for ovarian cancer.

The Midwest has high ovarian cancer mortality rates overall and very limited numbers of gynecologic oncologists, most of which are concentrated in a small number of large, academic medical centers. The state of Iowa, for example, has six gynecologic oncologists, five of which are located at the same medical center. The largely rural population in the Midwest likely experiences distance and access barriers to high-quality ovarian cancer treatments. In addition, there is general lack of awareness among patients about the importance of receiving treatment from gynecologic oncologists, which may lead them to be reluctant to travel long distances to meet with a gynecologic oncologist.