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.
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.
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.
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.
Cancer. 2024 Aug 19 [Epub ahead of print]
Nita H Mukand, Ekaterina Chirikova, Daphne Lichtensztajn, Serban Negoita, Tamer Aboushwareb, John Bennett, James D Brooks, John T Leppert, Benjamin I Chung, Christopher Li, Stephen M Schwartz, Susan T Gershman, Tabassum Insaf, Bozena M Morawski, Antionette Stroup, Xiao-Cheng Wu, Jennifer A Doherty, Valentina I Petkov, Joao Paulo Zambon, Scarlett Lin Gomez, Iona Cheng
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA., Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California, USA., Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA., Pacific Edge Limited, Dunedin, New Zealand., Exact Sciences, Redwood City, California, USA., Department of Urology, Stanford Medicine, Palo Alto, California, USA., Cancer Surveillance System, Fred Hutchinson Cancer Center, Seattle, Washington, USA., Massachusetts Department of Public Health, Boston, Massachusetts, USA., Bureau of Cancer Epidemiology, New York State Health Department, Albany, New York, USA., Cancer Data Registry of Idaho, Boise, Idaho, USA., New Jersey Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA., Louisiana Tumor Registry, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA., Utah Cancer Registry, University of Utah, Salt Lake City, Utah, USA., MDxHealth, Irvine, California, USA.