Knowledge, expectations, and attitudes related to genomic tumor testing (GTT) varied by education level and income among patients who were surveyed about GTT in a recent study. Results were reported in the journal JCO Precision Oncology.

Patient perceptions of emerging technologies in cancer care and other social determinants of health may impact health outcomes. “Since cancer care disparities result from intersecting social, psychological, and clinical factors, an increased understanding of GTT may improve disparities if patients know when to advocate for appropriate testing,” the study investigators wrote in their report.

Genomic tumor testing is an emerging technology that may improve the precision of cancer care, with large-panel GTT analyses seeing increasing use. “However, the growing interest and use of GTT have raised concerns about widening health inequities in underserved populations given high costs of testing and related treatments,” the study investigators wrote in their report. Additionally, they noted, patient attitudes about this technology could impact its use.

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In this study, patients at community oncology practices in Maine were surveyed to measure their level of rurality, sociodemographic features, and knowledge and perspectives regarding GTT. The investigators used the patient survey results to identify patterns in GTT knowledge, expectations, and attitudes in relation to patient characteristics. They performed analyses that were controlled for patient age, sex, cancer site, and clinical cancer stage.

There were 1066 survey respondents included in this study, with a mean age of 64 years. Most (72%) participants were living in rural areas, more than half (57%) had a household income of less than $50,000, and approximately two-thirds (67.8%) did not have a college degree.

In one analysis, a higher level of rurality was associated with a lower level of knowledge about GTT (P =.017). However, in an analysis that also incorporated educational level and household income, there was no significant association between rurality and knowledge (P =.2).

The analysis including educational level and income also showed other patterns. A greater level of knowledge about GTT was associated with higher income in this model (P <.001), and GTT knowledge was associated with higher educational attainment (P <.001). Attitudes about GTT were more positive in patients with a higher income (P =.004).

In addition, this analysis showed a negative association between educational level and expectations of GTT benefits (P <.001). Expectations of a benefit with GTT were higher among urban patients than among those in large rural areas (P =.011). However, attitudes regarding GTT did not appear to show an independent association with rurality (P =.14).

“In conclusion, in multivariable models, patients’ knowledge, expectations, and attitudes about GTT vary by education and income level and urban patients had higher expectations of GTT than patients from large rural areas,” the study investigators wrote. They also noted that knowledge about GTT was lower and expectations were higher in more socially disadvantaged patients.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


DiBiase JF, Scharnetzki E, Edelman E, et al; MCGI Working Group. Urban-rural and socioeconomic differences in patient knowledge and perceptions of genomic tumor testing. JCO Precis Oncol. 2023;7:e2200631. doi:10.1200/PO.22.00631