Disparities in Next-Generation Genetic Sequencing Among Individuals with Cancer

Background We sought to investigate disparities in the utilization of next-generation genetic sequencing (NGS) across demographic groups related to several  common cancer subtypes. Methods Data on patients aged 65 years or older with a diagnosis of gastrointestinal, lung, and breast cancer between 2...

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Published in:Annals of surgical oncology 2024-11, Vol.32 (2), p.650-652
Main Authors: Khan, Muhammad Muntazir Mehdi, Khalil, Mujtaba, Stecko, Hunter, Pawlik, Timothy M.
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description Background We sought to investigate disparities in the utilization of next-generation genetic sequencing (NGS) across demographic groups related to several  common cancer subtypes. Methods Data on patients aged 65 years or older with a diagnosis of gastrointestinal, lung, and breast cancer between 2015 and 2020 were obtained from the Medicare Standard Analytic Files. Propensity score matching was employed to reduce selection bias, and logistic regression analysis was performed to investigate racial, ethnic, and sex-based disparities in NGS utilization. Results Among 1,466,105 individuals, only 1.8% ( n  = 26,608) underwent NGS. Median patient age was 76 years (IQR 71–82), 36.8% ( n  = 539,201) of patients were male, and 87.8% ( n  = 1,287,805) were non-Hispanic White. Of note, minority patients, including non-Hispanic Black individuals (no NGS: 7.2% vs. NGS: 5.2%) and Hispanics (no NGS: 0.9% vs. NGS: 0.5%), as well as individuals residing in socially vulnerable neighborhoods (no NGS: 32.6% vs. NGS: 30.7%) were less likely to undergo NGS testing (all p  
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Methods Data on patients aged 65 years or older with a diagnosis of gastrointestinal, lung, and breast cancer between 2015 and 2020 were obtained from the Medicare Standard Analytic Files. Propensity score matching was employed to reduce selection bias, and logistic regression analysis was performed to investigate racial, ethnic, and sex-based disparities in NGS utilization. Results Among 1,466,105 individuals, only 1.8% ( n  = 26,608) underwent NGS. Median patient age was 76 years (IQR 71–82), 36.8% ( n  = 539,201) of patients were male, and 87.8% ( n  = 1,287,805) were non-Hispanic White. Of note, minority patients, including non-Hispanic Black individuals (no NGS: 7.2% vs. NGS: 5.2%) and Hispanics (no NGS: 0.9% vs. NGS: 0.5%), as well as individuals residing in socially vulnerable neighborhoods (no NGS: 32.6% vs. NGS: 30.7%) were less likely to undergo NGS testing (all p  &lt; 0.001). On multivariable analysis, non-Hispanic Black race/ethnicity (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.69–0.78), Hispanic race/ethnicity (OR 0.64, 95% CI 0.53–0.77), and males (OR 0.97, 95% CI 0.94–0.99) remained at lower odds of undergoing NGS. Conclusion Non-Hispanic Black and Hispanic patients, along with socioeconomically vulnerable individuals, were less likely to undergo NGS. Addressing these inequities is crucial to ensure that all patients have equal opportunities to receive effective, personalized cancer care that is equitable across diverse populations.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-16464-6</identifier><identifier>PMID: 39523293</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>ASO Research Letter ; Medicine ; Medicine &amp; Public Health ; Oncology ; Surgery ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2024-11, Vol.32 (2), p.650-652</ispartof><rights>Society of Surgical Oncology 2024</rights><rights>2024. Society of Surgical Oncology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c228t-b26aebae432b37c0c08ea795c53b80647c93b7e523a15e895c829fa8e9d927ed3</cites><orcidid>0000-0002-7994-9870</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39523293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khan, Muhammad Muntazir Mehdi</creatorcontrib><creatorcontrib>Khalil, Mujtaba</creatorcontrib><creatorcontrib>Stecko, Hunter</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><title>Disparities in Next-Generation Genetic Sequencing Among Individuals with Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background We sought to investigate disparities in the utilization of next-generation genetic sequencing (NGS) across demographic groups related to several  common cancer subtypes. Methods Data on patients aged 65 years or older with a diagnosis of gastrointestinal, lung, and breast cancer between 2015 and 2020 were obtained from the Medicare Standard Analytic Files. Propensity score matching was employed to reduce selection bias, and logistic regression analysis was performed to investigate racial, ethnic, and sex-based disparities in NGS utilization. Results Among 1,466,105 individuals, only 1.8% ( n  = 26,608) underwent NGS. Median patient age was 76 years (IQR 71–82), 36.8% ( n  = 539,201) of patients were male, and 87.8% ( n  = 1,287,805) were non-Hispanic White. Of note, minority patients, including non-Hispanic Black individuals (no NGS: 7.2% vs. NGS: 5.2%) and Hispanics (no NGS: 0.9% vs. NGS: 0.5%), as well as individuals residing in socially vulnerable neighborhoods (no NGS: 32.6% vs. NGS: 30.7%) were less likely to undergo NGS testing (all p  &lt; 0.001). On multivariable analysis, non-Hispanic Black race/ethnicity (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.69–0.78), Hispanic race/ethnicity (OR 0.64, 95% CI 0.53–0.77), and males (OR 0.97, 95% CI 0.94–0.99) remained at lower odds of undergoing NGS. Conclusion Non-Hispanic Black and Hispanic patients, along with socioeconomically vulnerable individuals, were less likely to undergo NGS. Addressing these inequities is crucial to ensure that all patients have equal opportunities to receive effective, personalized cancer care that is equitable across diverse populations.</description><subject>ASO Research Letter</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Oncology</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PAzEMhiMEolD4AwzoRpaDfF8yogKlUkUHYI5yObekanMluePj35NSYGSxLfv1K_tB6IzgS0K5uEoEc8ZLTHlJJJe8lHvoiIjc4lKR_VxjqUpNpRig45SWGJOKYXGIBkwLyqhmR2h249PGRt95SIUPxQN8dOUYAkTb-TYU27LzrniE1x6C82FRXK_bHCeh8W--6e0qFe--eylGNjiIJ-hgnltw-pOH6Pnu9ml0X05n48noelo6SlVX1lRaqC1wRmtWOeywAltp4QSrFZa8cprVFeQrLRGg8kBRPbcKdKNpBQ0booud7ya2-bLUmbVPDlYrG6Dtk2GEqoprLFiW0p3UxTalCHOziX5t46ch2GxBmh1Ik0Gab5BG5qXzH_--XkPzt_JLLgvYTpDyKCwgmmXbx5B__s_2C5Orfkk</recordid><startdate>20241110</startdate><enddate>20241110</enddate><creator>Khan, Muhammad Muntazir Mehdi</creator><creator>Khalil, Mujtaba</creator><creator>Stecko, Hunter</creator><creator>Pawlik, Timothy M.</creator><general>Springer International Publishing</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7994-9870</orcidid></search><sort><creationdate>20241110</creationdate><title>Disparities in Next-Generation Genetic Sequencing Among Individuals with Cancer</title><author>Khan, Muhammad Muntazir Mehdi ; Khalil, Mujtaba ; Stecko, Hunter ; Pawlik, Timothy M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c228t-b26aebae432b37c0c08ea795c53b80647c93b7e523a15e895c829fa8e9d927ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>ASO Research Letter</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Oncology</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khan, Muhammad Muntazir Mehdi</creatorcontrib><creatorcontrib>Khalil, Mujtaba</creatorcontrib><creatorcontrib>Stecko, Hunter</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khan, Muhammad Muntazir Mehdi</au><au>Khalil, Mujtaba</au><au>Stecko, Hunter</au><au>Pawlik, Timothy M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disparities in Next-Generation Genetic Sequencing Among Individuals with Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2024-11-10</date><risdate>2024</risdate><volume>32</volume><issue>2</issue><spage>650</spage><epage>652</epage><pages>650-652</pages><issn>1068-9265</issn><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background We sought to investigate disparities in the utilization of next-generation genetic sequencing (NGS) across demographic groups related to several  common cancer subtypes. Methods Data on patients aged 65 years or older with a diagnosis of gastrointestinal, lung, and breast cancer between 2015 and 2020 were obtained from the Medicare Standard Analytic Files. Propensity score matching was employed to reduce selection bias, and logistic regression analysis was performed to investigate racial, ethnic, and sex-based disparities in NGS utilization. Results Among 1,466,105 individuals, only 1.8% ( n  = 26,608) underwent NGS. Median patient age was 76 years (IQR 71–82), 36.8% ( n  = 539,201) of patients were male, and 87.8% ( n  = 1,287,805) were non-Hispanic White. Of note, minority patients, including non-Hispanic Black individuals (no NGS: 7.2% vs. NGS: 5.2%) and Hispanics (no NGS: 0.9% vs. NGS: 0.5%), as well as individuals residing in socially vulnerable neighborhoods (no NGS: 32.6% vs. NGS: 30.7%) were less likely to undergo NGS testing (all p  &lt; 0.001). On multivariable analysis, non-Hispanic Black race/ethnicity (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.69–0.78), Hispanic race/ethnicity (OR 0.64, 95% CI 0.53–0.77), and males (OR 0.97, 95% CI 0.94–0.99) remained at lower odds of undergoing NGS. Conclusion Non-Hispanic Black and Hispanic patients, along with socioeconomically vulnerable individuals, were less likely to undergo NGS. Addressing these inequities is crucial to ensure that all patients have equal opportunities to receive effective, personalized cancer care that is equitable across diverse populations.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39523293</pmid><doi>10.1245/s10434-024-16464-6</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0002-7994-9870</orcidid></addata></record>
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Medicine
Medicine & Public Health
Oncology
Surgery
Surgical Oncology
title Disparities in Next-Generation Genetic Sequencing Among Individuals with Cancer
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