ASPO Abstracts
Trends and Patterns of Next Generation Sequencing among Cancer Patients in Florida
Category: Molecular Epidemiology & Environment
Conference Year: 2023
Abstract Body:
Purpose of the Study: Next-generation sequencing (NGS) testing has been widely implemented and expanded coverage for cancer patients as a component of precision oncology care; however, little is known about its utilization trends and patterns. We investigated real-world evidence of NGS utilization among cancer patients and providers. Methods: Data were derived from OneFlorida Data Trust, which consisted of electronic health records data from 10 health systems in Florida. We identified patients with diagnosis of any cancer type using ICD-9 and 10 between 2012 and 2021. CPT codes 81445, 81450, or 81455 were used to capture NGS testing. Patient characteristics included age at diagnosis, year of diagnosis, race/ethnicity, sex, insurance type, ZIP code-based household income and education level, cancer site, and Charlson Comorbidity Index (CCI). We conducted bivariate analysis to compare differences in patient characteristics by NGS testing. Results: Among 688,577 patients with cancer diagnosis (mean age, 62.4 years old; 52.0% female; 50.2% non-Hispanic White), 5,334 (0.8%) had NGS testing. Median time to NGS testing since cancer diagnosis was 65 days (IQR: 9-562). NGS testing rate increased significantly (P for trend <.001) from 2.9 in 2012 to 7.8 per 1,000 person-years in 2021. Cancer patients who had NGS were more likely to be younger than 50 years old (21.2% vs. 17.8%), non-Hispanic White (55.7% vs. 50.1%), and covered by private insurance (26.8% vs. 20.9%) compared with those who did not (all Ps <.001). Patient ZIP code-based household income or education level was not associated with NGS testing. In terms of clinical characteristics, those who had NGS testing were more likely to have multiple cancer diagnoses (71.8% vs. 37.2%) but less comorbidity burden (22.4% with CCI 4+ vs. 28.8%) (all Ps <.001). Among those having NGS testing, 19.4% were diagnosed with leukemia, followed by colorectal (17.5%) and lung (13.8%) cancers. Conclusions: Although NGS utilization among cancer patients in Florida increased significantly over the past decade, its overall utilization remains low (<1%). Older, racial/ethnic minorities, and those with public insurance coverage were less likely to undergo NGS testing, suggesting potential socioeconomic disparities in access to NGS.
Keywords: Next-Generation Sequencing; OneFlorida; Cancer Genetic Testing