ArticleCancer medicine2025
Socioeconomic- and Insurance-Based Inequities in Oncotype DX Testing and Score-Guided Treatment.
Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Socioeconomic- and Insurance-Based Inequities in Oncotype DX Testing and Score-Guided Treatment.Cancer medicine · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
purposePersonalized approaches to breast cancer treatment are increasingly guided by expensive, lab-based genomic testing like Oncotype DX (ODX) Breast Recurrence Score Test. Little is known about how socioeconomic and insurance status may affect utilization of ODX testing and subsequent ODX score-guided treatment.
methodsThis retrospective cohort study included women diagnosed with early-stage, HR+/HER2- breast cancer from 2011 to 2023 within the US-based, electronic health record (EHR)-derived, deidentified Flatiron Health Research Database. Socioeconomic status was measured by a census block-level measure of neighborhood deprivation. Insurance status was captured at the time of diagnosis. Utilization of ODX testing was compared descriptively. Age-stratified likelihood of adjuvant chemotherapy by neighborhood deprivation or insurance status was estimated using relative risk, predicted probabilities, and 95% confidence intervals from adjusted Poisson models.
resultsOf 3814 patients eligible for ODX testing, 47% were commercially insured, and 31% lived in an impoverished neighborhood. Compared to those without, patients with an ODX test (47%, n = 1797) were more often white (81% vs. 74%), commercially insured (50% vs. 44%), or lived in an affluent neighborhood (72% vs. 66%). For patients aged ≤ 50 with low recurrence risk, patients who resided in affluent vs. impoverished neighborhoods had a 5% higher probability of receiving potentially inappropriate overtreatment with adjuvant chemotherapy. Of those with low/medium recurrence risk, publicly insured patients had more than double the probability of receiving adjuvant chemotherapy compared to those privately insured, suggesting potential overtreatment. For patients aged > 50 with ODX with high recurrence risk, Medicare beneficiaries had a 5% lower probability than privately insured patients and an 11% lower probability than Medicaid/Other beneficiaries of receiving recommended adjuvant chemotherapy, suggesting under treatment.
conclusionSocioeconomic- and insurance-based inequities, including both overtreatment and undertreatment, were observed in this EHR-based cohort of women with early-stage breast cancer eligible for ODX testing, indicating opportunities to increase care quality.
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