Evaluating health disparities in access to genomic testing for metastatic non-small cell lung cancer patients.

Yoon, Brian; Weeraratne, Dilhan; Arriaga, Yull; Huang, Hu; Osterman, Travis

doi:10.1200/jco.2020.39.28_suppl.113

Cited by 3 publications

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“…Health disparities exist in genomic testing in patients with NSCLC. A large study by Yoon et al 30 showed that male, White patients were more likely to receive genomic testing. Another study from Massachusetts General Hospital showed that low-income status and older age were associated with lower rates of genetic testing.…”

Section: Discussionmentioning

confidence: 99%

Improving Time to Molecular Testing Results in Patients With Newly Diagnosed, Metastatic Non–Small-Cell Lung Cancer

Ossowski

Neeman

Borden

et al. 2022

JCO Oncology Practice

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PURPOSE: Next-generation sequencing (NGS) is a crucial component of evaluation of patients with newly diagnosed metastatic non–small-cell lung cancer (NSCLC) to determine appropriate first-line treatment. This quality improvement project aimed to reduce time to NGS results in patients with metastatic NSCLC. METHODS: We reviewed electronic medical records of patients with newly diagnosed, untreated metastatic NSCLC from December 2018 to August 2021 and determined the number of days from pathologic diagnosis to NGS results. We reviewed process maps for oncology, pathology, the Division of Research, and a NGS vendor to determine factors leading to preventable delays. Since November 2020, we created an automated, electronic weekly report to provide earlier identification of new pathologic diagnoses in patients with metastatic NSCLC. On June 2021, we worked with our NGS vendors to expand days of the week to accept specimens. RESULTS: Our interventions reduced the median time from pathologic diagnosis to NGS results from 24 (standard deviation [SD] 9) to 16 (SD 6) days. The median time from biopsy results to NGS order was reduced from 7 days to 1 day. The time from the specimen being sent from pathology to the NGS vendor was a median of 6 days in both cohorts. The total time from pathologic diagnosis to appropriate treatment was reduced from 33 (SD 18) to 22 (SD 8) days. CONCLUSION: NGS processing in a community setting can be complex. Using a systems focused approach to quality improvement is crucial in identifying the greatest barriers in an organization. We found that delays in time to NGS results can be reduced by improved communication and workflows among departments.

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Section: Discussionmentioning

confidence: 99%

Improving Time to Molecular Testing Results in Patients With Newly Diagnosed, Metastatic Non–Small-Cell Lung Cancer

Ossowski

Neeman

Borden

et al. 2022

JCO Oncology Practice

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Urban-Rural and Socioeconomic Differences in Patient Knowledge and Perceptions of Genomic Tumor Testing

DiBiase

Scharnetzki

Edelman

et al. 2023

JCO Precision Oncology

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PURPOSE Social determinants of health, such as rurality, income, and education, may widen health disparities by driving variation in patients' knowledge and perceptions of medical interventions. This effect may be greatest for medical technologies that are hard to understand and less accessible. This study explored whether knowledge and perceptions (expectations and attitudes) of patients with cancer toward large-panel genomic tumor testing (GTT), an emerging cancer technology, vary by patient rurality independent of other socioeconomic characteristics (education and income). METHODS Patients with cancer enrolled in a large precision oncology initiative completed surveys measuring rurality, sociodemographic characteristics, and knowledge and perceptions of GTT. We used multivariable linear models to examine differences in GTT knowledge, expectations, and attitudes by patient rurality, education, and income level. Models controlled for age, sex and clinical cancer stage and type. RESULTS Rural patients had significantly lower knowledge of GTT than urban patients using bivariate models ( P = .025). However, this association disappeared when adjusting for education and income level: patients with lower educational attainment and lower income had lower knowledge and higher expectations ( P ≤ .002), whereas patients with higher income had more positive attitudes ( P = .005). Urban patients had higher expectations of GTT compared with patients living in large rural areas ( P = .011). Rurality was not associated with attitudes. CONCLUSION Patients' education and income level are associated with knowledge, expectations, and attitudes toward GTT, whereas rurality is associated with patient expectations. These findings suggest that efforts to promote adoption of GTT should focus on improving knowledge and awareness among individuals with low education and income. These differences may lead to downstream disparities in GTT utilization, which should be explored in future research.

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Advancing Equity in Oncology: Innovative Approaches and Robust Frameworks to Address Cancer Health Disparities

LaPelusa,

Khan,

Deville

et al. 2023

International Journal of Cancer Care and Delivery

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The 2023 Summit on Cancer Health Disparities took place from April 28 through April 30, 2023. This manuscript summarizes three pivotal talks that underscored significant discussions on cancer inequities. Dr. Hiba Khan’s session, “Rising Tide of Biomarker Selected Studies – How Genomic Testing is Key to Unlocking Inequities in Oncology Clinical Trial Access,” delved into the vital role genomic testing plays in eliminating disparities within oncology clinical trials. The next session by Dr. Curtiland Deville, titled “Advanced Imaging and Stage Migration – How Findings More Diseases May Lead to More Opportunities,” explored how advanced imaging and disease stage migration can unearth further opportunities for equitable treatment access. Lastly, Dr. Samuel Washington’s presentation, “Applying a Social Determinant of Health Framework to Address Clinical Trial Inequities,” offered a thorough exploration into the use of social determinants of health as a strategy to rectify clinical trial inequities. Under the guidance of the session’s chair, Dr. Hala Borno, these presentations foster a nuanced understanding of cancer disparities, emphasizing the importance of innovative approaches and robust frameworks to bridge the gap in cancer care and research. This summary is an essential reference point for practitioners, policymakers, and stakeholders invested in overcoming the profound challenge of cancer disparities.

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Evaluating health disparities in access to genomic testing for metastatic non-small cell lung cancer patients.

Cited by 3 publications

References 0 publications

Improving Time to Molecular Testing Results in Patients With Newly Diagnosed, Metastatic Non–Small-Cell Lung Cancer

Improving Time to Molecular Testing Results in Patients With Newly Diagnosed, Metastatic Non–Small-Cell Lung Cancer

Urban-Rural and Socioeconomic Differences in Patient Knowledge and Perceptions of Genomic Tumor Testing

Advancing Equity in Oncology: Innovative Approaches and Robust Frameworks to Address Cancer Health Disparities

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