Socioeconomic and urban-rural disparities in genome-matched treatment receipt and survival after genomic tumor testing.

Autor:	DiBiase JF; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA., Scharnetzki E; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA., Edelman E; The Jackson Laboratory, Augusta, ME, USA., Reed EK; The Jackson Laboratory, Augusta, ME, USA., Helbig P; The Jackson Laboratory, Augusta, ME, USA., Rueter J; The Jackson Laboratory, Augusta, ME, USA., Miesfeldt S; Cancer Risk and Prevention Program, Maine Medical Center Cancer Institute and MaineHealth Cancer Care Network, Scarborough, ME, USA., Frankenfeld CL; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA., Han PKJ; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA.; Tufts University School of Medicine, Boston, MA, USA.; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA., Jacobs EA; Tufts University School of Medicine, Boston, MA, USA., Anderson EC; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Westbrook, ME, USA.; Tufts University School of Medicine, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	JNCI cancer spectrum [JNCI Cancer Spectr] 2024 Sep 02; Vol. 8 (5).
DOI:	10.1093/jncics/pkae090
Abstrakt:	Background: Emerging cancer treatments are often most available to socially advantaged individuals. This study examines the relationship of patient educational attainment, income level, and rurality to the receipt of genome-matched treatment and overall survival. Methods: Survey and clinical data were collected from patients with cancer (n = 1258) enrolled in the Maine Cancer Genomics Initiative. Logistic regression models examined whether receipt of genome-matched treatment differed by patient education, income, and rurality. Kaplan-Meier curves and Cox regression were conducted to evaluate 12-month mortality. We completed additional exploratory analyses using Kaplan-Meier curves and Cox models stratified by receipt of genome-matched treatment. Logistic and Cox regression models were adjusted for age and gender. Results: Educational attainment, income level, and rurality were not associated with genome-matched treatment receipt. Of 1258 patients, 462 (36.7%) died within 365 days of consent. Mortality risk was associated with lower educational attainment (hazard ratio [HR] = 1.30, 95% confidence interval [CI] = 1.06 to 1.59; P = .013). No statistically significant differences in mortality risk were observed for income level or rurality. Exploratory models suggest that patients who did not receive genome-matched treatment with lower educational attainment had higher mortality risk (HR = 1.36, 95% CI = 1.09 to 1.69; P = .006). For patients who did receive genome-matched treatment, there was no difference in mortality risk between the education groups (HR = 1.01, 95% CI = 0.56 to 1.81; P > .9). Conclusion: Although there were no disparities in who received genome-matched treatment, we found a disparity in mortality associated with education level, which was more pronounced for patients who did not receive genome-matched treatment. Future research is warranted to investigate the intersectionality of social disadvantage with clinical outcomes to address survival disparities. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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