Research Mentor Name

Dr. Clara Hwang

Research Mentor Email Address

chwang2@hfhs.org

Institution / Department

Henry Ford Health, Department of Internal Medicine, Division of Hematology and Oncology

Document Type

Research Abstract

Research Type

publichealth

Level of Research

no

Abstract

Introduction

Germline genetic testing in patients with advanced prostate cancer (PCa) is underutilized. Socioeconomic and demographic factors are hypothesized to affect low rates of testing, but causality has not been established. This single institution, retrospective study aimed to understand what barriers may affect germline genetic testing for PCa patients.

Methods

The Henry Ford Health (HFH) tumor registry was queried for new diagnoses of stage 3, 4A and 4B PCa from 2017-2022. Census tract levels were assigned using patient addresses and neighborhood-based geocoding was completed for Median household income (gMHI) and Social vulnerability index (SVI). gMHI and SVI were divided into tertiles. Outcomes were referral for genetic counseling and completion of genetic testing. Univariable and multivariable logistic regression analyses were performed.

Results

Multivariable analysis identified a decrease in testing by 3% for each 1-year increase in age (OR=0.97, 95% CI [0.95,0.99]; p=.0052). Middle gMHI tertile patients had 52% lower OR for referral than lowest gMHI tertile patients (OR=0.48, 95% CI [0.30, 0.78]; p=0.0027). For completion of testing, the odds were 2.84 times higher for those with substage 4B than 4A (OR=2.84, 95% CI [1.70, 4.74]; p<.0001). No significant association was shown between gMHI and completion of testing.

Conclusion

Although socioeconomic factors have been hypothesized barriers to genetic testing, we found no evidence of such an association in our patient population. Instead, lowest gMHI tertile patients were equally likely to complete genetic testing as highest gMHI tertile patients, indicating that if such barriers exist, they can be overcome.

Disciplines

Community Health and Preventive Medicine | Oncology | Translational Medical Research

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