Concetti Chiave
Older age, lower educational level in the area of residence, community-setting treatment, and treatment at East South Central facilities are associated with lower rates of microsatellite instability (MSI) and KRAS biomarker testing in patients with metastatic colorectal cancer.
Sintesi
This study analyzed data from the National Cancer Database to investigate disparities in biomarker testing for patients with metastatic colorectal cancer (CRC) across the United States. The researchers evaluated the association between various sociodemographic factors and the likelihood of undergoing MSI and KRAS testing.
Key findings:
- Only 28.8% of patients underwent KRAS testing, and 43.7% underwent MSI testing in the overall cohort.
- Factors associated with a lower likelihood of MSI testing included:
- Older age (70-79 age group had the lowest odds)
- Treatment at a community (vs. academic) cancer center
- Living in a rural (vs. metropolitan) area
- Lower educational level in the area of residence
- Treatment at East South Central facilities (vs. New England)
- Similar factors were linked to lower levels of KRAS testing:
- Older age (70-79 age group)
- Lower educational level in the area of residence
- Treatment at a community cancer center or East South Central facilities
- Medicaid (vs. private) insurance
- The survival analysis showed that MSI and KRAS testing were associated with modest improvements in overall survival, after adjusting for confounders.
The authors emphasize the need to develop strategies for promoting equity in cancer care and improving outcomes for underserved populations by addressing these sociodemographic-based disparities in biomarker testing.
Statistiche
Only 28.8% of patients underwent KRAS testing, and 43.7% underwent MSI testing in the overall cohort.
Patients in the 70-79 age group had the lowest odds of MSI testing compared to the 18-49 age group (relative risk [RR], 0.70).
Patients treated at a community (vs. academic) cancer center had a lower likelihood of MSI testing (RR, 0.74).
Patients living in a rural (vs. metropolitan) area had a lower likelihood of MSI testing (RR, 0.80).
Patients living in an area with a lower educational level had a lower likelihood of MSI testing (RR, 0.84).
Patients treated at East South Central facilities (vs. New England) had a lower likelihood of MSI testing (RR, 0.67).
Patients in the 70-79 age group had a lower likelihood of KRAS testing compared to the 18-49 age group (RR, 0.81).
Patients living in an area with a lower educational level had a lower likelihood of KRAS testing (RR, 0.92).
Patients treated at a community cancer center had a lower likelihood of KRAS testing (RR, 0.92).
Patients treated at East South Central facilities had a lower likelihood of KRAS testing (RR, 0.78).
Patients with Medicaid (vs. private) insurance had a lower likelihood of KRAS testing (RR, 0.94).
Citazioni
"In this cohort study of patients with [metastatic] CRC, older age, lower educational level in area of residence, community-setting treatment, and treatment at East South Central facilities were associated with a lower likelihood of MSI and KRAS testing."
"By highlighting the sociodemographic-based disparities in biomarker testing using national registries, we can develop strategies for promoting equity in cancer care and improving outcomes for underserved populations."