New Study Finds Correlation Between Race and Lung Cancer Testing

A group of researchers at the Institute for Translational Epidemiology at the Icahn School of Medicine at Mount Sinai, wanted to explore why there were higher lung cancer mortality rates reported among minorities.

Emanuela Taioli, M.D., Ph.D.

“We kept seeing that novel technologies and therapies are not equally accessible to all strata of patients,” Emanuela Taioli, M.D., Ph.D., director of the Institute for Translational Epidemiology, who led the study, told Managed Healthcare Executive. “For example, we had previously observed that minorities are less likely to receive immunotherapy for lung cancer and wondered if one of the reasons was because few of them were tested for molecular markers that define the eligibility to personalized therapy such as immunotherapy.”

Their study results, published in the Journal of the National Cancer Institute on Sept. 10, 2024, showed that molecular testing did, in fact, vary by race and income. .

Taioli and her team used data from 28,511 NSCLC patients and found 11,209 (39.3%) received molecular diagnostic testing. They found that 40.4% of White patients had been tested compared with just 27.9% of Black patients. They also found that people from areas of high poverty were less likely to be tested.

From the data, the researchers concluded that disparities exist in comprehensive molecular diagnostics, which is critical for clinical decision making, and addressing these barriers could help close gaps in cancer care and improve patient outcomes.
The “why” of their finding can’t be answered by their research because they used insurance claims data, Taioli said. But she and her colleagues have some ideas about the reasons.

One possibility is that these patients receive care in less specialized centers and smaller practices, where novel approaches “are not routinely embraced,” Taioli said.
“Access to quality care, to specialized cancer centers would likely address inequalities in testing,” Taioli said. “This is such a novel area of research, there is very little published on disparities in testing. However, I suspect that the patient is not in the position to choose to be tested or not. This is a decision that the physician makes. Probably best is to educate the patients to prefer specialized cancer centers in order to get quality care.”

One of the hopes of the study is that national guidelines will become stricter and require all centers to perform molecular testing when applicable and clinically indicated.