Trends and disparities in the use of next-generation sequencing in patients with cancer in the United States

Life-prolonging targeted therapies may be available based on alterations detected on next-generation sequencing (NGS); however, clinical data on NGS adoption are limited. A retrospective cohort study of 280 US-based cancer clinics (approximately 800 sites of care) investigated trends and disparities in the use of NGS among 63,294 patients with metastatic breast cancer (mBC; 19.1%), metastatic prostate cancer (mPC; 6.9%), advanced non-small cell lung cancer (aNSCLC; 42.7%), metastatic colorectal cancer (mCRC; 21.6%), or metastatic pancreatic cancer (mPanC; 9.7%) between 2018 and 2022. One-year cumulative incidence of NGS increased in patients diagnosed in 2022 compared with 2018 across all cancer types. However, most patients did not undergo tumor genomic testing. Patients with low socioeconomic status, Black or Hispanic patients, and those covered by Medicaid or Medicare experienced significantly longer time to testing in some of these cancers compared with their respective reference groups. The authors conclude that these findings suggest that disparities persist in genomic testing and underscore the need for interventions to ensure equitable access to precision oncology.