ArticleJournal of the National Cancer Institute2025
Racial and socioeconomic disparities in non-small cell lung cancer molecular diagnostics uptake.
Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are There Socio-Demographic Inequalities in the Utilisation of Tumour and ctDNA Somatic Mutation Testing in Solid Tumours? A Systematic Review.Cancer medicine · 2026Pooled it
- Development of clinical-radiological prediction models to prioritizeJournal of thoracic disease · 2026Article
- Multiple Primary Lung Cancers in Surgical Patients: Revisiting Martini and Melamed 50 Years Later.Cancers · 2026Article
- Biomarker testing patterns among patients newly diagnosed with metastatic non-small cell lung cancer, prostate cancer, and bladder cancer.The oncologist · 2026Article
- Toward multi-domain lung cancer research databases: opportunities and challenges from MCC-MELD.Journal of thoracic disease · 2026Article
- Applications of artificial intelligence in non-small cell lung cancer: from precision diagnosis to personalized prognosis and therapy.Journal of translational medicine · 2025Review
- Association between advanced lung cancer inflammation index and postoperative mortality in lung cancer patients: a retrospective cohort study.European journal of medical research · 2025Article
- Management of advanced non-small cell lung cancer withJournal of thoracic disease · 2025Article
- Equity and Opportunities in Lung Cancer Care-Addressing Disparities, Challenges, and Pathways Forward.Cancers · 2025Review
- Ethical considerations of genetic and genomic testing in pediatric oncology: A narrative review.CA: a cancer journal for cliniciansReview
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Authors and funding
6 authors.
Funding
Abstract
backgroundPrecision therapies, such as targeted and immunotherapies, have substantially changed the landscape of late-stage non-small cell lung cancer (NSCLC). Yet, utilization of these therapies is disproportionate across strata defined by race and socioeconomic status, possibly because of disparities in molecular diagnostic testing (or biomarker testing), which is a prerequisite to treatment.
methodsWe extracted a cohort of NSCLC patients from the Surveillance, Epidemiology, and End Results-Medicare linked data. The primary outcome was receipt of a molecular diagnostic test, based on claims data. The primary predictors were race and socioeconomic status. Likelihood of receiving a molecular diagnostic test and overall survival were investigated using logistic and Cox proportional hazards regression, adjusted for sex, age, residence, histology, marital status, and comorbidity.
resultsOf the 28 511 NSCLC patients, 11 209 (39.3%) received molecular diagnostic testing. Compared with White patients, fewer Black patients received a molecular diagnostic test (40.4% vs 27.9%; P < .001). After adjustment, Black patients (adjusted odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.58 to 0.71) and those living in areas with greater poverty (adjusted OR = 0.85, 95% CI = 0.80 to 0.89) had statistically significant decreased likelihood of molecular diagnostic testing. Patients who did receive testing had a statistically significant decreased risk of death (adjusted hazard ratio [HR] = 0.74, 95% CI = 0.72 to 0.76). These results held in the stratified analysis of stage IV NSCLC patients.
conclusionDisparities exist in comprehensive molecular diagnostics, which is critical for clinical decision making. Addressing barriers to molecular testing could help close gaps in cancer care and improve patient outcomes.
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