The Impact of the Area Deprivation Index on Development of Homologous Recombination Deficiency in Ovarian Cancer

Homologous recombination deficiency (HRD) is a critical genetic mechanism contributing to the development of ovarian cancer (OC). This study investigates the potential relationship between the Area Deprivation Index (ADI), defined as a measure of socioeconomic disadvantage, and the prevalence of HRD and related genetic mutations in epithelial ovarian cancer (EOC). Data were extracted from 532 cases enrolled in a biobanking study at the University of Pittsburgh Medical Center and Hillman Comprehensive Cancer Center from 2006 to 2023. Genetic testing results were analyzed in terms of ADI state decile and national percentile rankings to assess correlations. While no significant associations were found between ADI and HRD status, tumor mutation status, or germline genetic results, a few trends were observed in certain subgroups, including higher platinum sensitivity and improved progression free survival in HRD positive cases. Limitations of this study encompass small sample sizes for some genetic subgroups, limited geographic diversity, and variability in testing methods. These findings suggest that while ADI may not directly influence genetic mechanisms of HRD, future studies with more diverse populations and standardized testing approaches are needed to clarify potential socioeconomic impacts on OC biology and outcomes. This research highlights the complexity of OC etiology and the importance of integrating clinical, genetic, and socioeconomic factors in future studies to advance personalized treatment strategies.