About

Ashley Felix is an Associate Professor of Epidemiology and serves as the Interim Chair of Health Behavior and Health Promotion at The Ohio State University. She is affiliated with the Institute for Population Research, where her contact information includes the office located at 060 Townshend Hall, Neil Ave Mall, Columbus, OH. Her professional focus involves health and mortality, contributing to research and academic initiatives within the university's broader efforts in population research and health sciences.

Research topics

• Pathology
• Internal medicine
• Medicine
• Environmental health
• Gynecology

Selected publications

• More than treatment refusal: a National Cancer Database analysis of adjuvant treatment refusal and racial survival disparities among women with endometrial cancer

  American Journal of Obstetrics and Gynecology · 2022 · 15 citations

  • Medicine
  • Internal medicine
  • Gynecology
  DOI

• Abstract A134: Minority women with non-endometrioid endometrial cancer are not less likely to receive guideline-concordant treatment than White women

  Cancer Epidemiology Biomarkers & Prevention · 2020

  Senior authorCorresponding
  • Medicine
  • Gynecology
  • Internal medicine

  Abstract Background: Black women with endometrial cancer (EC) experience significant disparities in treatment and survival. They undergo diagnostic evaluation, primary surgical management, and non-surgical treatment at statistically lower rates than non-Hispanic White (NHW) women. Black women are also more likely to present with advanced stage disease and aggressive tumor histology, including non-endometrioid EC subtypes, resulting in a 93% greater overall mortality rate than Whites. Research in other cancers show that Black patients receive guideline-concordant care less often than NHW women. To date, no study has assessed the relationship between race and receipt of comprehensive guideline-concordant therapy, nor have studies examined the impact of guideline- concordant treatment and survival according to race among women with EC. We investigated these associations among women diagnosed with non-endometrioid EC in the National Cancer Database. Methods: Our analysis included 21,696 NHW, 6,859 non-Hispanic Black (NHB), 1,752 Hispanic, and 922 Asian/Pacific Islander (AS/PI) women diagnosed with non-endometrioid EC between 2004 and 2014. We used year-specific National Comprehensive Cancer Network (NCCN) guidelines to classify treatment as guideline-concordant vs. not concordant. We used multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for the association between race and receipt of guideline-concordant treatment in models adjusted for age at diagnosis, stage, histology, comorbidity score, insurance type, and facility type. We used multivariable-adjusted Cox proportional hazards models to estimate hazards ratios (HRs) and 95% CIs for relationships between receipt of guideline-concordant treatment and overall survival stratified by race. Results: In the overall study population, 38.2% of women with non-endometrioid EC received NCCN guideline-concordant treatment. Compared to NHW women, NHB women (OR=1.05, 95% CI=0.99 to 1.11), Hispanic women (OR=1.10, 95% CI=0.99 to 1.23) and AS/PI women (OR=1.11, 95% CI=0.97 to 1.28) did not have significantly different odds of receiving guideline-concordant treatment in multivariable-adjusted models. Receipt of guideline-concordant treatment was significantly associated with improved survival among NHW (HR=0.84, 95% CI=0.80 to 0.87), NHB (HR=0.86, 95% CI=0.80 to 0.92), and Hispanic women (HR=0.85, 95% CI=0.72 to 1.00) but not among AS/PI women (HR=0.88, 95% CI=0.71 to 1.10). Conclusions: Almost two-thirds of women with non-endometrioid EC may not receive guideline-concordant treatment. We observed no difference in receipt of concordant care between racial groups. When received, guideline-concordant treatment was associated with improved survival in almost all racial groups. Therefore, instituting interventions to improve adherence to guideline-concordant treatment may contribute to reducing racial disparities in survival for women with non-endometrioid EC. Citation Format: Jhalak Dholakia, Elyse Reamer, Ritu Salani, Ashley Felix. Minority women with non-endometrioid endometrial cancer are not less likely to receive guideline-concordant treatment than White women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A134.

  DOI

• Where you live matters: A National Cancer Database study of Medicaid expansion and endometrial cancer outcomes

  Gynecologic Oncology · 2020 · 22 citations

  • Medicine
  • Oncology
  • Gynecology
  DOI

Frequent coauthors

• Fábio Q. B. da Silva

  Universidade Federal de Pernambuco

  1 shared

• Amir Pasha Mahmoudzadeh

  1 shared

• C. Franca

  Universidade Federal de Viçosa

  1 shared

• Renata Cora

  1 shared

• Stephen M. Hewitt

  1 shared

• Gretchen L. Gierach

  1 shared

• Deesha A. Patel

  1 shared

• Elyse Reamer

  The Ohio State University

  1 shared

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