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Oncologist-Reported Reasons for Not Ordering Multimarker Tumor Panels: Results From a Nationally Representative
Megan C Roberts1,2, Lisa P Spees2,3, Andrew N Freedman4
1Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract:
This study examines oncologist-reported reasons for not using multimarker tumor panel testing and the association between these reasons and oncologist-level, facility-level, and patient-mix characteristics.
Methods:
We used data collected from a nationally representative sample (N = 1,281) of medical oncologists participating in the National Cancer Institute's National Survey of Precision Medicine in Cancer Treatment.
Results:
In addition to testing not being seen as relevant (87%) and no evidence of test utility (77%), the most frequently reported reasons for not ordering a multimarker tumor panel test was difficulty in obtaining sufficient tissue (57%) and using individual gene tests (72%). These reasons were more likely to be reported by oncologists practicing in rural clinics and less likely to be reported by oncologists with an academic affiliation or with access to genetic services such as on-site genetic counselors and internal genetic testing policies.
Conclusion:
Modifiable, organizational factors were associated with ordering multimarker tumor panels. Receipt of genomics training and organizational policies related to the use of genomics were associated with lower reporting of barriers to ordering multimarker tumor panels, pointing to potential targets for future studies aimed at increasing appropriate multimarker tumor panel testing in cancer treatment management.
Insights
Oncologists often don't use multimarker tumor panel testing due to perceived irrelevance or lack of evidence. Organizational factors like genomics training and policies can reduce these barriers to cancer treatment.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Multimarker tumor panel testing is crucial for personalized cancer treatment.
- Understanding barriers to its use is essential for improving patient care.
Purpose of the Study:
- To examine oncologist-reported reasons for not using multimarker tumor panel testing.
- To identify associations between these reasons and oncologist, facility, and patient characteristics.
Main Methods:
- Analysis of data from a nationally representative sample of 1,281 medical oncologists.
- Utilized the National Cancer Institute's National Survey of Precision Medicine in Cancer Treatment.
Main Results:
- Key reasons for not ordering tests include: testing not seen as relevant (87%), no evidence of utility (77%), insufficient tissue (57%), and preference for individual gene tests (72%).
- Barriers were more common in rural settings and less common among oncologists with academic affiliations or genetic services.
Conclusions:
- Modifiable organizational factors, such as genomics training and policies, are linked to fewer reported barriers.
- These factors represent potential targets for future studies to increase appropriate multimarker tumor panel testing in cancer care.
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