Study Suggests Racial Disparities in Accessing Genomic Test Data

There have long been documented health care disparities by race, but a new study by UCLA researchers zeroes in on how data from a molecular test for breast cancer informs minority patients about their treatment options. According to Ninez Ponce, associate director for the UCLA Center for Health Policy Research and the senior author of the study, the test is OncoTypeDX, which was created and is distributed by Pathway Genomics in Redwood City, Calif.

According to the mail and online survey of 890 Californians who had been diagnosed with early stage breast cancer and took the test, 90 percent were aware that they had taken the blood-based assay, which undertakes gene expression profiling of their tumor. But 20 percent of the patients in the study were unaware of the results of that test.

Ninety-eight percent of Asian-American women and 94 percent of white women were aware that they had been tested. But only 78 percent of Latinas and 85 percent of African-American women were aware they had been tested.

And while 7 percent of all women who tested for breast cancer that had a low risk for recurrence underwent chemotherapy, 15 percent of Latinas and 11 percent of African-Americans underwent such treatment, which can have adverse side effects such as extreme nausea and the loss of hair. About 7 percent of white patients underwent chemotherapy as well, but only about 2 percent of Asian-American women did.

The results are a concern to researchers, who not only believe the disparities are preventing some women of color from receiving appropriate care, but should raise some worries among labs, which are designing such tests specifically to reduce unnecessary utilization and health care costs.

"No one should have to go through the stress and discomfort of chemo without understanding the personal risks and benefits," Ponce said. "At the very least, patients should know their options. Right now, some women may be making treatment decisions based on incomplete information."

Ponce suggested a customized educational campaign may be needed to eliminate such disparities.

Takeaway: Even with equal access to genomic tests, some minority women may not be receiving actionable data.