Disparities in precision medicine-Examining germline genetic counseling and testing patterns among men with prostate cancer.
Disparities in precision medicine-Examining germline genetic counseling and testing patterns among men with prostate cancer.
复制标题
DOI：
10.1016/j.urolonc.2020.10.014
复制
发表时间：
2021-04
影响因子：
2.7
通讯作者：
Rider, Jennifer R.
中科院分区：
文献类型：
--
作者：
Borno, Hala T.;Odisho, Anobel Y.;Gunn, Christine M.;Pankowska, Magdalena;Rider, Jennifer R.
本研究旨在探讨生殖系遗传咨询和检测是否在前列腺癌患者中因种族和/或民族以及其他社会因素而存在差异。在这项回顾性分析中，从电子健康记录中确定了研究期间（2011年4月至2020年8月）列为访视诊断的所有前列腺癌患者。收集患者的特征沿着遗传咨询师的访问和电子健康记录中的生殖系基因检测结果。进行多变量分析，主要结局定义为接受遗传咨询访视和接受遗传检测。共有14，610名前列腺癌诊断代码的患者被确定。大多数患者为白色（72%）、年龄≥ 65岁（62.7%）、讲英语（95%）、已婚（71.4%）和公共保险（58.7%）。共有667名患者完成了与遗传咨询师的预约。共有439名患者接受了生殖系基因检测结果，其中403名（91.8%）还完成了与遗传咨询师的预约。65岁或以上（校正比值比0.53，95%CI 0.44-0.65）和非英语熟练（校正比值比0.71，95%CI 0.42-1.21）的患者接受遗传咨询的可能性较小。接受遗传咨询是接受基因检测的最强独立预测因素。目前的研究结果强调了社会因素在前列腺癌男性遗传咨询和检测中的作用。这些结果强调了开发新策略以解决观察到的差异（包括语言，年龄和保险状况）的重要性。
This study sought to examine whether germline genetic counseling and testing were employed differentially among men with prostate cancer by race and/or ethnicity and other social factors. In this retrospective analysis, all patients with prostate cancer listed as a visit diagnosis during the study period (April 2011 to August 2020) were identified from electronic health records. Patient characteristics were collected along with genetic counselor visits and germline genetic testing results in electronic health records. Multivariable analyses were performed with the primary outcome defined as the receipt of a genetic counseling visit and receipt of genetic testing. A total of 14,610 patients with a prostate cancer diagnosis code were identified. The majority of patients were White (72%), aged >=65 years (62.7%), English-speaking (95%), married (71.4%), and publicly insured (58.7%). A total of 667 patients completed an appointment with a genetic counselor. A total of 439 patients received germline genetic test result, of whom 403 (91.8%) had also completed an appointment with a genetic counselor. Patients that were 65 years or older (adjusted odds ratio 0.53, 95%CI 0.44–0.65) and non-English proficient (adjusted odds ratio 0.71, 95%CI 0.42–1.21) were less likely to receive genetic counseling. Receiving genetic counseling was the strongest independent predictor of receipt of genetic testing. The results of the current study highlight that the role of social factors in contributing to disparities in genetic counseling and testing among men with prostate cancer. These results underscore the importance of developing novel strategies to tackle contributors of observed disparities including language, age, and insurance status.
登录
查看更多内容
影响因子：
3.4
作者：
Frazier, Lorraine;Calvin, Amy O.;Cohen, Marlene Z.
通讯作者：
Cohen, Marlene Z.
影响因子：
--
作者：
PEREZSTABLE, EJ;OTEROSABOGAL, R;HIATT, RA
通讯作者：
HIATT, RA
影响因子：
4.4
作者：
Viswanath, K.;Breen, Nancy;Rakowski, William
通讯作者：
Rakowski, William
影响因子：
120.7
作者：
Berland, GK;Elliott, MN;McGlynn, EA
通讯作者：
McGlynn, EA
影响因子：
1.4
作者：
Richardson, Amanda;Allen, Jane Appleyard;Vallone, Donna
通讯作者：
Vallone, Donna