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Researchers discover substantial regional variation in use of genomic testing for prostate most cancers

Gene expression tests provide better estimates of the aggressiveness of cancer and aid decision-making in treating men with prostate cancer. In a new study from the Yale Cancer Center, researchers found significant regional differences in the use of genomic tests for prostate cancer and asked questions about access and other factors that could fuel the rapid adoption of new cancer technologies. The study is published online today in the journal JAMA Oncology.

Little was known about how genomic testing was used in routine clinical care. We wanted to understand national absorption patterns in regions in the United States. One of the interesting things we uncovered was the extent of regional differences in the use of genomic tests. “

Michael Leapman, MD, assistant professor of urology, clinical program director of the Prostate and Urologic Cancer Program at Smilow Cancer Hospital and Yale Cancer Center, and lead author of the study

The study examined data from 92,418 patients, ages 40 to 89, diagnosed with prostate cancer between 2012 and 2018, using insurance claims from Blue Cross Blue Shield Axis®, the largest source of data on health insurance claims, providers and costs. Researchers looked for trends in the use of tests and used some form of statistical modeling to uncover groups of regions that had similar uptake patterns. The results indicated that the rollout of commercial tissue-based genomic testing for prostate cancer at the regional level has varied widely across the US, and may be linked to contextual action on socioeconomic status and patterns of prostate cancer treatment.

“In some regions, genomic testing was minimally used or not used at all, while in other regions there was only a high degree of use, meaning the decisions being tested are highly discretionary,” Leapman said. “In addition, there were groups of geographically unrelated regions that have shown a similar rate of growth over time. These findings raise questions about common factors that could fuel the rapid adoption of new cancer technologies.”

Study scientists added that more research is needed to clarify the contribution of patient-level factors to testing, as well as the effectiveness of these tests in improving clinical decision-making.

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