Assessing sociodemographic and regional disparities in Oncotype DX Genomic Prostate Score uptake

• Published in: Cancer 2024-12, Vol.130 (24), p.4298-4305
• Main Authors: Mukand, Nita H., Chirikova, Ekaterina, Lichtensztajn, Daphne, Negoita, Serban, Aboushwareb, Tamer, Bennett, John, Brooks, James D., Leppert, John T., Chung, Benjamin I., Li, Christopher, Schwartz, Stephen M., Gershman, Susan T., Insaf, Tabassum, Morawski, Bozena M., Stroup, Antionette, Wu, Xiao‐Cheng, Doherty, Jennifer A., Petkov, Valentina I., Zambon, Joao Paulo, Gomez, Scarlett Lin, Cheng, Iona
• Format: Article
• Language: English
• Subjects: Aged; Census; Clustering; Diagnosis; Epidemiology; Ethnicity; Gene expression; genomic medicine; Genomics; Genomics - methods; Global positioning systems; GPS; health inequities; health services accessibility; Healthcare Disparities - statistics & numerical data; Humans; Male; Middle Aged; Minority & ethnic groups; Neoplasm Grading; Prostate cancer; prostatic neoplasms; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - genetics; Prostatic Neoplasms - pathology; Regional analysis; SEER Program; Social Class; social determinants of health; Sociodemographic Factors; Sociodemographics; socioeconomic disparities and health; Socioeconomic Factors; Socioeconomics; Spatial data; Statistical analysis; United States - epidemiology
• ISSN: 0008-543X; 1097-0142; 1097-0142
• DOI: 10.1002/cncr.35511

Background The Oncotype DX Genomic Prostate Score (ODX‐GPS) is a gene expression assay that predicts disease aggressiveness. The objective of this study was to identify sociodemographic and regional factors associated with ODX‐GPS uptake. Methods Data from Surveillance Epidemiology and End Results registries on men with localized prostate cancer with a Gleason score of 3 + 3 or 3 + 4, PSA ≤20 ng/mL, and stage T1c to T2c disease from 2013 through 2017 were linked with ODX‐GPS data. Census‐tract level neighborhood socioeconomic status (nSES) quintiles were constructed using a composite socioeconomic score. Multivariable logistic regression was used to estimate the associations of ODX‐GPS uptake with age at diagnosis, race and ethnicity, nSES, geographic region, insurance type, and marital status, accounting for National Comprehensive Cancer Network risk group, year of diagnosis, and clustering by census tract. Results Among 111,434 eligible men, 5.5% had ODX‐GPS test uptake. Of these, 78.3% were non‐Hispanic White, 9.6% were Black, 6.7% were Hispanic, and 3.6% were Asian American. Black men had the lowest odds of ODX‐GPS uptake (odds ratio, 0.70; 95% confidence interval [CI], 0.63–0.76). Those in the highest versus lowest quintile of nSES were 1.64 times more likely (95% CI, 1.38–2.94) to have ODX‐GPS uptake. The odds of ODX‐GPS uptake were statistically significantly higher among men residing in the Northeast, West, and Midwest compared to the South. Conclusions Disparities in ODX‐GPS uptake by race, ethnicity, nSES, and geographical region were identified. Concerted efforts should be made to ensure that this clinical test is equitably available. Among 2013–2017 cases of localized prostate cancer from the Surveillance, Epidemiology, and End Results registries, Black men, Hispanic men, and men living in the South had the lowest odds of Oncotype DX Genomic Prostate Score (ODX‐GPS) ordering. Oncotype DX‐GPS ordering increased monotonically with increasing neighborhood socioeconomic status at diagnosis.