About

Anna Jo Bodurtha Smith, MD, MPH, MSc, is an Assistant Professor of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania. She holds a medical degree from Harvard Medical School, an MPH from the London School of Hygiene and Tropical Medicine, and an MSc from the London School of Economics. Her research focuses on gynecologic oncology, health disparities, and health economics, with numerous publications on topics such as social determinants of health, disparities in clinical trial participation, and the implementation of immunotherapy in recurrent endometrial cancer. Dr. Smith is actively involved in clinical care as an attending physician at multiple hospitals and medical centers, including the Penn Presbyterian Medical Center, Chester County Hospital, and the Hospital of the University of Pennsylvania. She also contributes to academic initiatives as a fellow at the Center for Public Health Initiatives and as adjunct faculty at the University of Pennsylvania Center for Health Incentives and Behavioral Economics.

Research topics

• Medicine
• Internal medicine
• Oncology
• Family medicine
• Gynecology

Selected publications

• Author response for "Clinician Nudge to Gynecologic Oncology Referral at Suspected Ovarian Cancer Diagnosis: A Pilot Study"

  2026-01-05

  peer-review1st authorCorresponding
  PublisherDOI

• Clinician Nudge to Gynecologic Oncology Referral at Suspected Ovarian Cancer Diagnosis: A Pilot Study

  Cancer Control · 2026-02-19

  articleOpen access1st authorCorresponding

  IntroductionOnly two-thirds of patients with ovarian cancer ever see a gynecologic oncologist. Our objective was to examine the feasibility of an electronic health record-based nudge to clinicians for referral to gynecologic oncology at suspected ovarian cancer by imaging.MethodsWe developed a nudge, a short behavioral economics informed best practice advisory with a pended referral order for gynecologic oncology, for primary care, emergency medicine, and obstetrician/gynecology clinicians for when a patient had a O-RADS 4 or 5 lesion on imaging and had not already seen gynecologic oncology. In 2024, clinicians were sent the nudge within 2 business days of a patient's abnormal imaging through the electronic health record. Our primary outcome was referral rate to gynecologic oncology compared to a historic cohort of patients with O-RADS 4 or 5 lesions from 2020-2023.ResultsIn this prospective cohort study, we sent 20 clinician nudges for gynecologic oncology referral; six clinicians (30%) responded that the nudge changed their referral behavior. The 90-day referral rate was 75% compared to historic baseline of 61%. In the pilot, 92% patients undergoing surgery for complex adnexal mases had surgery with gynecologic oncology compared to historic baseline of 82%. One in four patients in the pilot were diagnosed with cancer, all early-stage disease.ConclusionsA clinician nudge for gynecologic oncology referral at suspected ovarian cancer diagnosis was acceptable and associated with 75% referral rate. A clinician nudge standardizes gynecologic oncology referral and may improve early detection of ovarian cancer. A randomized controlled trial of the clinician nudge is warranted.

  PublisherDOI

• Gynecologic cancers in veterans and military service members compared to non-veterans, 2004–2021: A National cancer database study

  Gynecologic Oncology Reports · 2026-05-06

  articleOpen access1st authorCorresponding

  Objective: Women are the fastest growing demographic within the military-Veteran population in the United States. Our objective was to characterize gynecologic cancer occurrence, and trends over time, in Veterans and service members compared to non-veterans. Methods: We performed a retrospective cohort study using National Cancer database comparing cancer occurrence, age at diagnosis, histology, and survival among veterans and service members compared to non-veterans from 2004 to 2021. Results: Annual new gynecologic cancer diagnoses increased among Veterans from 301 in 2004 to 883 in 2021. Veterans now account for 1% of gynecologic cancer diagnoses nationwide. Veterans were diagnosed with gynecologic cancers at younger ages and earlier stages than non-veterans. Cancer histologies differed from non-veterans with endometrioid uterine cancer, germ cell ovarian cancer, and cervical adenocarcinoma being more common in Veterans. Overall survival was similar among Veterans and non-Veterans. Conclusions: As the proportion of women in the military has grown, gynecologic cancer diagnoses and survivorship among service members and Veterans are increasing. Further work is needed to understand the epidemiology of gynecologic cancer and optimize gynecologic cancer prevention and care delivery for service members and Veterans.

  PublisherDOI

• Demographics and inclusion in ovarian cancer screening studies: A review

  Gynecologic Oncology · 2025-09-01

  reviewSenior author
  PublisherDOI

• P161 Missed opportunities? Reviewing Hhepatitis D testing in new hepatitis B diagnoses in Northern Ireland

  2025-10-01

  article1st authorCorresponding

  <h3>Background</h3> Current NICE guidelines for Hepatitis B virus (HBV) recommend that all newly diagnosed patients should be tested for Hepatitis D virus (HDV) in primary care. In Northern Ireland (NI), all HBV diagnostic testing is performed by the Regional Virology Laboratory (RVL). All new cases of HBV are referred to a centralised, regional viral hepatitis clinic based in Belfast. Prior to 2022, fewer than 10 HDV tests were sent annually, with none returning a positive result. A cluster of new HDV cases was identified in 2022 leading to a look back exercise. A new protocol was introduced in June 2023 to ensure all new HBV patients were tested for HDV at first clinic visit. <h3>Aim</h3> The aim of this review was to evaluate compliance with this new protocol in the 12 months following its implementation and to identify obstacles to testing <h3>Method</h3> A list of all newly diagnosed HBV cases between 1/6/23 and 31/5/24 was compiled following review of RVL records. The medical records of these patients were subsequently examined for evidence of referral to/attendance at the regional viral hepatitis clinic. Where patients had attended, evidence of HDV testing was sought in RVL records. <h3>Results</h3> 120 new HBV cases were identified during the study period. Eleven patients were excluded from the study as a result of insufficient demographic data to identify the patient. Of these remaining 109 patients, 107 were referred to viral hepatitis clinic, with 80 (74.8%) patients having been seen in clinic to date. Of the 80 patients seen in clinic, 35 (43.8%) patients were tested for HDV. In two patients where tests were sent, these were rejected for laboratory reasons. These patients did not have repeat tests sent. No positive HDV results were returned <h3>Conclusion</h3> Despite an established protocol, only 43.8% of new HBV cases were tested for HDV upon attendance at a regional viral hepatitis clinic. Potential obstacles to testing include reduced awareness of the protocol amongst staff at the clinic and also that, whilst other blood tests were requested electronically as part of a panel, HDV testing required an additional, separate, paper form. We recommend that reflex testing for HDV in newly diagnosed HBV cases should be considered in NI, which is a low prevalence region for HDV.

  PublisherDOI

• Representation of HE4 in clinical trials as a biomarker for ovarian malignancy risk: A review

  Gynecologic Oncology · 2025-09-01

  review1st authorCorresponding
  PublisherDOI

• Modifiable disparities in guideline-concordant chemotherapy in ovarian cancer: A National Cancer Database study

  Gynecologic Oncology · 2025-09-01

  articleSenior author
  PublisherDOI

• Financial navigation in gynecologic oncology: A mixed methods study

  Gynecologic Oncology · 2025-09-01

  article
  PublisherDOI

• Caregiver distress: Caring for those who care for our patients.

  Journal of Clinical Oncology · 2025-05-28

  article

  11115 Background: Gynecologic cancers cause high physical and psychosocial strain, worsened by unmet social determinants of health (SDOH) in cancer care. Caregivers help patients access and complete treatment, and increased caregiver distress, especially in vulnerable populations, is linked to worse patient outcomes in chronic illnesses. This study aimed to assess caregiver distress and SDOH in a diverse gynecologic cancer population, understand the relationship between caregiver and patient distress, explore how caregiver distress evolves during chemotherapy, and examine its effect on short-term patient outcomes. Methods: A prospective pilot study was conducted of patients starting chemotherapy for gynecologic cancer and their self-identified caregivers at a single academic site after IRB approval. Patient distress was measured with the NCCN Distress Thermometer. Caregivers completed the Modified Caregiver Strain Index (MCSI) and SDOH questionnaires at enrollment (T0) and three months after chemotherapy initiation (T3). Descriptive statistics, χ² analyses, and linear regression analyzed differences between high- and low-distress caregivers and changes between time points. Results: Between 12/2023 and 06/2024, 60 patients and 38 caregivers enrolled. Patients’ mean age was 62, with 27% identifying as Black and 37% as Hispanic. Most (72%) were starting chemotherapy for initial treatment of uterine (47%), ovarian (32%), cervical (20%), and vulvar (1.6%) cancer, and 73% had stage III/IV disease. Caregivers were 63% male, 40% Hispanic, 24% Black, and 26% over age 65. Almost 40% of caregivers did not live with their patient, and 27% cared for others, including 80% for children. Nearly 40% had incomes under $50,000; only 13.2% had paid job-related support. At T0, 77% of patients reported high distress, decreasing to 70% at T3. Caregivers of high-distress patients were younger, working full-time, and had lower incomes. At T0, 42% of caregivers reported high distress, increasing to 66% at T3. MCSI scores rose significantly from 5.84 at T0 to 9.84 at T3 (p&lt;0.001). At T0, 63% of caregivers screened positive for ≥1SDOH domain, rising to 80% by T3. Caregivers with ≥1 SDOH domain at T3 were more likely to experience increased distress (p=0.037). Linear regression showed caregivers with one SDOH domain had MCSI scores 3.69 points higher (p=0.111); those with ≥2 domains scored 5.60 points higher (p=0.024). No differences were found in patient outcomes based on caregiver MCSI scores. Conclusions: Caregiver distress and SDOH needs increase significantly during the first months of chemotherapy for gynecologic cancer. Distress is also more pronounced in caregivers with greater SDOH needs. Long-term studies are needed to evaluate caregiver distress and its impact on patient survival. This study highlights the importance of monitoring caregiver well-being and addressing SDOH through targeted interventions.

  PublisherDOI

• Comparing cancer antigen 125 thresholds by postmenopausal status and race: Performance analysis

  Gynecologic Oncology · 2025-09-01

  article1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Emily Ko

  University of Pennsylvania

  84 shared

• Amanda N. Fader

  67 shared

• Jeremy Applebaum

  Hospital of the University of Pennsylvania

  56 shared

• Edward J. Tanner

  53 shared

• George T. Capone

  Kennedy Krieger Institute

  50 shared

• Steven G. Deeks

  University of California, San Francisco

  40 shared

• Stephanie L. Wethington

  36 shared

• Ashley Haggerty

  33 shared

Labs

• Anna Jo Bodurtha Smith LabPI

Awards & honors

• Fellow, Center for Public Health Initiatives, University of…
• Adjunct Faculty, University of Pennsylvania Center for Healt…
• Attending Physician, Gynecologic Oncology, Chester County Ho…
• Attending Physician, Gynecologic Oncology, Pennsylvania Hosp…
• Attending Physician, Gynecologic Oncology, Hospital of the U…