ASPO Abstracts
Variations in genomic testing across cancer sites and by demographic characteristics
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Study Objective: To identify demographic and clinical factors associated with receipt of
genomic testing in Ohioans diagnosed with either incident female breast, kidney, bladder,
prostate, colorectal, or lung cancer.
Methods: We used data from the 2009 linked Ohio Cancer Incidence Surveillance System
and Medicare files, and identified genomic testing using the appropriate procedure codes
in claims data. Our study population included 10,945 patients. Independent variables
examined were age at diagnosis (< 65, 65-74, 75+), sex, race (White or All Other), dual
enrollment in the Medicare and Medicaid program (or ‘dual’) as a marker for heightened
vulnerability, and advanced stage at diagnosis. We conducted multivariable logistic
regression analysis to identify correlates of genomic testing by cancer site.
Results: For all cancer sites combined, 11.1% were younger than 65, and 40.6% were
older than 75 years of age. Eighty eight percent were White, 47.0% were women, 13.9%
were duals, and one third were diagnosed with advanced-stage cancer. Overall, only
19.5% underwent genomic testing, ranging from a low of 6.7% in prostate cancer
patients, to a high of 39.3% in breast cancer patients. We observed considerable
variation in genomic testing by age, race, sex, dual status, and cancer stage across
cancer sites. Adjusting for the independent variables, being 75 years of age or older was
significantly and positively associated with increased likelihood of undergoing genomic
testing in breast (adjusted odds ratio: 1.17, 95% confidence interval: 1.04, 1.32), kidney
and bladder combined (1.29 (1.09, 1.53)), and prostate cancer patients (1.45 (1.12,
1.89)). Advanced-stage disease was associated with increased likelihood of genomic
testing in breast and colorectal cancer patients (1.40 (1.17, 1.67) and 3.07 (2.30, 4.11),
respectively), but with decreased likelihood in kidney and bladder cancer patients (0.66
(0.48, 0.91)). Finally, we note that White patients with lung cancer were significantly more
likely than others to undergo genomic testing (2.49 (1.29, 4.78)).
Conclusion: Our data from 2009 provide baseline statistics on genomic testing uptake in
Ohio. Data for subsequent years will help us to assess trends in providing personalized
medicine.
Keywords: Genomic Testing; Variations by patient characteristics