背景:OncotypeDX基因组前列腺评分(ODX-GPS)是一种预测疾病侵袭性的基因表达测定。这项研究的目的是确定与ODX-GPS摄取相关的社会人口统计学和区域因素。
方法:来自Gleason评分为3+3或3+4、PSA≤20ng/mL的局限性前列腺癌男性的监测流行病学和最终结果登记的数据,从2013年到2017年的T1c至T2c疾病阶段与ODX-GPS数据相关.使用综合社会经济评分构建了人口普查区水平的邻里社会经济地位(nSES)五分位数。多变量逻辑回归用于估计ODX-GPS摄取与诊断时年龄的关联。种族和民族,nSES,地理区域,保险类型,和婚姻状况,占国家综合癌症网络风险组,诊断年份,并按人口普查区域进行聚类。
结果:在111,434名合格男性中,5.5%具有ODX-GPS测试摄取。其中,78.3%是非西班牙裔白人,9.6%为黑色,6.7%是西班牙裔,3.6%是亚裔美国人。黑人ODX-GPS摄取的几率最低(优势比,0.70;95%置信区间[CI],0.63-0.76)。nSES最高和最低五分之一的人具有ODX-GPS摄取的可能性是其1.64倍(95%CI,1.38-2.94)。ODX-GPS摄取的几率在居住在东北部的男性中具有统计学意义。西,中西部与南部相比。
结论:种族ODX-GPS吸收的差异,种族,nSES,并确定了地理区域。应共同努力,以确保这种临床测试是公平的。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.