基于组织的生物标志物测试在美国医疗保险受益者与前列腺癌的差异
Stephan M Korn1,2, Zhiyu Qian1,3, Hanna Zurl1,4
1Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
JNCI cancer spectrum
|May 16, 2025
概括
针对前列腺癌的基于组织的生物标志物测试显示了显著的地理差异. 农村,黑人和西班牙裔患者不太可能接受这些先进的诊断测试,突出了获取差异.
科学领域:
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
- 医疗保健服务研究 医疗服务研究
背景情况:
- 针对前列腺癌的个性化药物越来越多地使用基于组织的生物标志物测试.
- 尽管覆盖率很高,但国家测试模式和地理差异仍然存在.
- 了解当前的利用率对于公平的护理至关重要.
研究的目的:
- 评估基于组织的前列腺癌生物标志物测试在全国范围内的使用情况.
- 调查城市和农村测试率的差异.
- 确定与测试差异相关的人口因素.
主要方法:
- 对医疗保险索赔数据 (2019-2023) 的回顾性分析.
- 包括新诊断的前列腺癌患者.
- 患者住所的分类 (地铁,城市,农村) 和区域测试率的分析.
- 多变量后勤回归用于评估居住地和种族/种族对测试收件的影响.
主要成果:
- 分析了749,202名患者的队列;11.6%接受了生物标志物测试.
- 医院转诊地区的检测率差异很大 (2.4%至42.7%).
- 与白人患者相比,农村患者 (OR 0.82),黑人 (OR 0.82) 和西班牙裔 (OR 0.80) 患者的测试几率较低.
结论:
- 在前列腺癌生物标志物测试中存在显著的地理差异.
- 种族和民族少数群体,特别是黑人和西班牙裔患者,在获得这些测试时面临差异.
- 调查结果强调需要解决区域实践差异,并尽量减少诊断获取不平等.
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