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Related Concept Videos

Genomics02:02

Genomics

Genomics is the science of genomes: it is the study of all the genetic material of an organism. In humans, the genome consists of information carried in 23 pairs of chromosomes in the nucleus, as well as mitochondrial DNA. In genomics, both coding and non-coding DNA is sequenced and analyzed. Genomics allows a better understanding of all living things, their evolution, and their diversity. It has a myriad of uses: for example, to build phylogenetic trees, to improve productivity and...

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A Robust Discovery Platform for the Identification of Novel Mediators of Melanoma Metastasis
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Medicare Insurance Type and Broad Genomic Profiling in Metastatic Cancer.

Ryan D Chow1, John Rothen2, Jessica B Long2

  • 1Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

JAMA Network Open
|May 27, 2026
PubMed
Summary
This summary is machine-generated.

Broad genomic profiling (BGP) use in metastatic cancer patients varied by Medicare type, with fee-for-service (FFS) beneficiaries showing higher rates than Medicare Advantage (MA). Significant geographic disparities in BGP use were also observed across regions.

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Area of Science:

  • Oncology
  • Health Services Research
  • Genomics

Background:

  • Broad genomic profiling (BGP) is recommended for metastatic cancers but underutilized.
  • Medicare Advantage (MA) cost-containment may limit BGP access.
  • Disparities in BGP use by Medicare payer type and geography are not well understood.

Purpose of the Study:

  • To compare BGP utilization between Medicare Advantage (MA) and fee-for-service (FFS) Medicare beneficiaries.
  • To assess geographic variations in BGP use across hospital referral regions (HRRs).

Main Methods:

  • Nationwide retrospective cohort study of Medicare beneficiaries (≥66 years) with new metastatic cancer diagnoses (Jan 2020-June 2022).
  • Utilized Medicare claims data to identify BGP receipt within 2 months before to 6 months after diagnosis.
  • Mixed-effects logistic regression analyzed associations between Medicare type and BGP use, controlling for covariates; HRR variation assessed using median odds ratio (MOR).

Main Results:

  • Of 254,720 beneficiaries, 25.3% received BGP; FFS beneficiaries had slightly higher use (25.8%) than MA (24.6%).
  • FFS beneficiaries showed higher BGP use for cancers with equivocal (AOR=1.15) and explicit (AOR=1.04) guideline recommendations.
  • Significant geographic variation in BGP use across HRRs was observed (median 24.5%, range 13.8%-35.9%).

Conclusions:

  • BGP use in metastatic cancer patients differs significantly by Medicare payer type (MA vs. FFS).
  • Substantial regional variations in BGP utilization exist across hospital referral regions.
  • Findings indicate opportunities to enhance guideline-concordant molecular testing access and equity.