Adherence Disparities and Utilization Trends of Oncotype Dx Assay: A National Cancer Database Study

Area of Science:

• Oncology
• Genomics
• Health Services Research

Background:

• Oncotype Dx (ODX) is a validated genetic assay for breast cancer recurrence risk and chemotherapy recommendations in early-stage, node-negative patients.
• Despite established guidelines, the utilization of Oncotype Dx remains suboptimal in eligible patient populations.
• Understanding adherence and utilization trends is crucial for optimizing breast cancer treatment strategies.

Purpose of the Study:

• To evaluate factors associated with adherence to Oncotype Dx testing guidelines.
• To examine trends in Oncotype Dx utilization among breast cancer patients.
• To identify disparities in access to Oncotype Dx testing.

Main Methods:

• Retrospective study using the National Cancer Database (2010-2017).
• Analysis of adherence to Oncotype Dx testing guidelines in eligible patients.
• Assessment of Oncotype Dx utilization trends in a broader patient cohort.

Main Results:

• Of 429,648 eligible patients, only 43.4% received Oncotype Dx testing.
• Factors associated with decreased ODX likelihood included advanced age, minority status, low income, and uninsured status.
• Testing was also performed on patients not meeting ODX criteria (e.g., node-positive, advanced stage).

Conclusions:

• Significant underutilization of Oncotype Dx in eligible breast cancer patients suggests care barriers and disparities.
• Expanding ODX use to non-guideline populations warrants further research to validate its effectiveness.
• Optimizing ODX use requires addressing access barriers and confirming its utility across diverse patient groups.