Genetic Testing Among Black and White Patients With Advanced Prostate Cancer: A Retrospective Analysis of Testing...

Area of Science:

• Oncology
• Genetics
• Health Disparities

Background:

• Genetic testing is crucial for advanced prostate cancer but underutilized.
• Racial disparities in healthcare access and outcomes are well-documented, particularly for Black patients.

Purpose of the Study:

• To assess and compare genetic testing completion rates between Black and White patients with advanced prostate cancer.
• To identify factors influencing disparities in genetic testing uptake.

Main Methods:

• Retrospective analysis of electronic medical records for stage IV prostate cancer patients (2017-2022).
• Comparison of somatic and germline testing completion rates by race.
• Multivariable logistic regression and Kaplan-Meier analysis to assess associations and survival outcomes.

Main Results:

• Black patients had higher somatic testing rates (30.7% vs. 18.9%).
• Germline testing was comparable overall but lower in Black patients with M1 disease (14.8% vs. 25.4%).
• Testing completion in M1 cases correlated with improved survival.

Conclusions:

• Overall genetic testing uptake remains low in advanced prostate cancer.
• While somatic testing shows equity, disparities persist in germline testing for Black patients with metastatic disease.
• Targeted interventions addressing systemic and patient-level barriers are needed to achieve equitable germline testing.