Where Women Live May Influence Ovarian Cancer Survival, Especially Among Black Women

8/10/2026

Women in socially vulnerable neighborhoods faced a 20% higher risk of death from ovarian cancer, and Black women faced a 45% higher risk than white women, Pitt-led research found.

PITTSBURGH — A University of Pittsburgh-led study found that women living in socially vulnerable neighborhoods faced a 20% higher risk of death after an ovarian cancer diagnosis than women in less vulnerable areas. Black women faced a 45% higher risk of death than white women. The findings were published Aug.10, 2026, in JAMA Network Open.

Key Takeaways

• A Pitt-led study of 2,544 women treated for epithelial ovarian cancer at the O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham found that women living in socially vulnerable neighborhoods, as measured by the CDC's Social Vulnerability Index, had a 20% higher risk of death than women in less vulnerable areas.

• The research, led by Francesmary Modugno, Ph.D., of the University of Pittsburgh, included 509 Black women and 2,035 white women and was conducted with collaborators from the University of Alabama at Birmingham, the University of South Carolina, the University of Kentucky and the Ri.MED Foundation.

• The findings build on 2025 research by Modugno and Pitt colleagues using UPMC Hillman Cancer Center data in western Pennsylvania, which linked neighborhood social vulnerability to ovarian cancer survival.

Epithelial ovarian cancer is the deadliest gynecologic cancer. About half of patients survive five years after diagnosis. Survival is lower for Black women, with fewer than 40% alive five years later. Differences in age at diagnosis, cancer stage and tumor type explain some of that gap, but a large share of the disparity remains unexplained.

"We expected residential context to influence outcomes, but what surprised us was how much stronger the impact was for Black women," said Francesmary Modugno, Ph.D., M.S., M.P.H., professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at Pitt and senior author of the study.

"Our findings suggest that it's not simply where someone lives. The interaction between a woman's lived experience and her residential environment may be helping drive these persistent disparities," added Modugno, who is a member of the Women's Cancer Research Center (WCRC), a collaboration between UPMC Hillman Cancer Center and Magee-Womens Research Institute. (MWRI).

How researchers linked neighborhood vulnerability to ovarian cancer survival

The study, conducted with researchers at the University of Alabama at Birmingham, analyzed data from 2,544 women diagnosed with epithelial ovarian cancer and treated at the O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham. The group included 509 Black women and 2,035 white women.

Researchers linked each patient's home census tract to the Centers for Disease Control and Prevention's Social Vulnerability Index. The Social Vulnerability Index scores neighborhoods on factors such as poverty, housing conditions, transportation access and educational attainment to identify communities facing the most social and economic strain.

Black women had worse survival than white women even when they lived in similarly advantaged neighborhoods. The combination of being Black and living in a highly vulnerable neighborhood carried a greater risk of death than either factor alone would suggest.

Support services that could help narrow the ovarian cancer survival gap

The findings point to opportunities for health systems and cancer programs to identify patients at higher risk and connect them with additional support. Examples include:

• Patient navigation programs

• Transportation assistance

• Childcare support

• Survivorship resources

"Our findings reinforce that we must better understand and address the barriers patients face in their communities and ensure that every woman has equitable access to high-quality care," said Rebecca Arend, M.D., M.S.P.H., associate professor of gynecology oncology in the Department of Obstetrics and Gynecology at the University of Alabama at Birmingham.

"Translating research into meaningful improvements in cancer outcomes is only possible through strong collaborations among academic medical centers, researchers and community partners," said Arend, who also serves as associate director of clinical research at the O'Neal Comprehensive Cancer Center.

Building on 2025 Pitt research linking neighborhood conditions to ovarian cancer survival

The study builds on research published in 2025 by Modugno and Pitt colleagues using data from UPMC Hillman Cancer Center in western Pennsylvania, which found that social vulnerability was associated with ovarian cancer survival. The new study adds a larger group of Black women and examines how neighborhood conditions may contribute to racial disparities in outcomes.

The findings will need to be tested in other regions of the country and among other racial and ethnic groups. Future studies will also look at other factors that may affect survival, including neighborhood pollution, food access and community resources.
The researchers said health systems could use neighborhood-level measures such as the Social Vulnerability Index in cancer care planning to identify patients facing barriers to care and connect them with support during treatment.

Frequently Asked Questions

Q: What did the Pitt-led study find about ovarian cancer survival and neighborhoods?
A: Women living in socially vulnerable neighborhoods faced a 20% higher risk of death after an ovarian cancer diagnosis than women in less vulnerable areas, and Black women faced a 45% higher risk of death than white women.

Q: What is the Social Vulnerability Index used in this ovarian cancer research?
A: It's a Centers for Disease Control and Prevention measure that scores neighborhoods on factors such as poverty, housing conditions, transportation access and educational attainment to identify communities facing the most social and economic strain.

Q: Does living in a disadvantaged neighborhood fully explain the racial gap in ovarian cancer survival?
A: No. The study found Black women had worse survival than white women even in similarly advantaged neighborhoods, and being Black while living in a highly vulnerable neighborhood carried a greater risk than either factor alone.

Additional Resources

• Published study: Residential Context and Survival Disparities in Black and White Women With Ovarian Cancer in JAMA Network Open

• EurekAlert! release: Where women live may influence ovarian cancer survival, especially among Black women

• Press contact: Allison Hydzik - hydzikam@upmc.edu

• Press contact: Andrea Yorchuck — KunickyA@upmc.edu

• Headshot of Francesmary Modugno, Ph.D., M.S., M.P.H., Credit: Rayni Shiring, University of Pittsburgh

Authors and Funding

Authors: Emily O'Brien, M.D., Lauren Borho, B.S., Austin Hicks, B.S., Nate Lindstrom, B.S., and Warner Huh, M.D., all of Pitt; Teresa Boitano, M.D., Charles Leath III, M.D., M.S.P.H., Haller Smith, M.D., Michael Toboni, M.D., M.P.H., Michael Straughn, M.D., and Rebecca Arend, M.D., M.S.P.H., all of the University of Alabama at Birmingham; Cai Chao, Ph.D., of the University of South Carolina; Nicolina Sciaraffa, Ph.D., and Claudia Coronnello, Ph.D., both of the Ri.MED Foundation; and Lyse Norian, Ph.D., and Justin Xavier Moore, Ph.D., M.P.H., both of the University of Kentucky.

Funding and Disclosures: Funding for this work was provided by the National Institutes of Health (5P50CA098252, P50CA272218, R21CA267050, R21CA301113, UG1CA233330), the Congressionally Directed Medical Research Program (W81XWH2110338), and the Janet Burroughs Ovarian Cancer Foundation.