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Biomarker testing for metastatic colorectal cancer (mCRC) is less common in older patients, those treated in community settings, or those from lower socioeconomic backgrounds. Addressing these disparities in microsatellite instability (MSI) and KRAS testing is crucial for equitable cancer care.

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Area of Science:

  • Oncology
  • Cancer Research
  • Health Services Research

Background:

  • Limited data exist on disparities in biomarker testing for metastatic colorectal cancer (mCRC) on a national scale.
  • Biomarker testing, including microsatellite instability (MSI) and KRAS, is crucial for guiding mCRC treatment.
  • Understanding socioeconomic and demographic inequities in testing is essential for improving patient outcomes.

Purpose of the Study:

  • To evaluate socioeconomic and demographic inequities in MSI and KRAS biomarker testing among patients with mCRC.
  • To explore the association between biomarker testing and overall survival (OS) in mCRC patients.

Main Methods:

  • A cohort study using data from the National Cancer Database (2010-2017).
  • Included 41,061 patients with mCRC and available biomarker testing information.
  • Used logistic regression to identify factors associated with MSI/KRAS testing and survival analysis for OS outcomes.

Main Results:

  • Only 28.8% of patients underwent KRAS testing and 43.7% received MSI testing.
  • Older age, community-setting treatment, lower educational level, and specific facility locations were associated with reduced testing likelihood.
  • MSI testing showed a modest improvement in overall survival (HR, 0.93).

Conclusions:

  • Significant sociodemographic disparities exist in MSI and KRAS testing for mCRC patients.
  • Factors such as age, treatment setting, and socioeconomic status influence testing rates.
  • Addressing these disparities is vital for promoting equity in cancer care and improving outcomes for underserved populations.