Genome atlas.

More and more data is establishing the clinical utility of genomic testing for prostate cancers. A Blue Cross Blue Shield administrative claims analysis examines trends in its actualized use. First, use among all examined cases nationwide increased more than 10-fold from 0.8% in 2012-13 to 11% in 2017-18. A deeper look, however, reveals stark distinctions in the adoption of genomic testing across regions. Trajectory modeling identified five clusters of geographic regions that shared similar patterns of testing. Though all five clusters began at <1% in 2012, regions with the lowest level reached a rate of only 4% by 2018 while those with the highest level were testing over one-third of patients. Predictably, hospital referral regions with the highest level of testing had higher median education, incomes, and physician densities. TBL: Even among commercially insured patients, regions with higher income and education levels are adopting genomic testing for prostate cancer more rapidly, which can contribute to disparities in the appropriateness of cancer treatments received. | Leapman, JAMA Onocl 2020