Knowledge, perceptions of genomic tumor testing vary based on socioeconomic factors
Click Here to Manage Email Alerts
Key takeaways:
- Both large rural and small/isolated rural patients had significantly less knowledge of genomic tumor testing than urban patients.
- The association disappeared after adjustment for income and education levels.
Knowledge, expectations and attitudes of patients with cancer about genomic tumor testing appeared to be associated with their respective education and income levels, according to a study published in JCO Precision Oncology.
“The primary finding is that although rurality was associated with lower knowledge in unadjusted models, that association went away when including education and income,” Jessica F. DiBiase, MPH, a research data analyst in the Center for Interdisciplinary Population & Health Research at MaineHealth Institute for Research, and colleagues wrote.
Background and methodology
Health disparities can widen due to certain social determinants of health — such as rurality, income and education — that drive variation in patients’ perceived knowledge of medical interventions, according to study background. These factors may have the greatest impact on use of more difficult and less accessible medical technologies, such as genomic tumor testing.
The study included 1,066 patients with cancer (mean age, 64 years; 95% white; 58% women) enrolled in a large precision oncology initiative who completed a survey measuring rurality, sociodemographic characteristics, and their respective knowledge and perceptions of genomic tumor testing.
Researchers used multivariable linear models to examine differences in knowledge, expectations and attitudes regarding genomic tumor testing based on patient rurality, education and income level. They designed the models to control for age, sex, and clinical cancer stage and type.
Results and next steps
Researchers noted that both large rural (b = 0.06; 95% CI, 0.11 to 0.01) and small/isolated rural patients (b = 0.07; 95% CI, 0.11 to 0.02) had significantly lower knowledge scores regarding genomic tumor testing than urban patients.
However, the association of rurality with lower knowledge did not appear when adjusting for education and income level, as patients with lower education and income levels had lower knowledge but higher expectations (P .002).
Patients with higher incomes exhibited more positive attitudes about genomic tumor testing (P = .005), whereas urban patients had higher expectations than patients living in large rural areas (P = .011).
Rurality did not appear associated with attitudes about genomic tumor testing, according to researchers.
Additional studies are needed to determine if increased awareness about genomic tumor testing would increase uptake and improve health outcomes, according to researchers.
“Since cancer care disparities result from intersecting social, psychological and clinical factors, an increased understanding of [genomic tumor testing] may improve disparities if patients know when to advocate for appropriate testing,” researchers wrote. “These findings suggest targeted outreach to low-income and lower-educational attainment patients, calibrating knowledge and expectations with the ultimate aim of improving uptake and goal-concordant care. Further research is needed to examine whether improving understanding of [genomic tumor testing] increases [genomic tumor testing] uptake and improves health outcomes.”
Collapse
Read more about
Click Here to Manage Email Alerts