Sociodemographic Factors Associated With Tissue-based Genomic Testing for Prostate Cancer.

[OBJECTIVE] To evaluate the association of patient and area-level sociodemographic factors associated with the use of genomic classifiers (GC) testing for localized prostate cancer (PCa). Although GC can improve stratification of PCa risk and facilitate personalization of treatment decision making, the factors influencing a patient's use of GCs remains poorly characterized.

[METHODS] We conducted a retrospective study to identify patients who were diagnosed with localized PCa from 2012-2022 and received genomic testing. We compiled clinical, Area Deprivation Index (ADI), and health insurance information. The primary study outcome was receipt of the GC assay from biopsy. Logistic regression analyses were used to evaluate the association between ADI and receipt of a GC test.

[RESULTS] Among 2103 eligible patients, 40.1% underwent genomic testing, and of those, 97.5% had available ADI information. A higher proportion of patients in the least deprived areas received genomic testing (40.9%) compared to those in the most deprived areas (34.6%) (P < .001). When adjusting for clinical and pathologic factors, age at time of biopsy, Hispanic ethnicity, and residence in a more deprived area were associated with lower odds of receiving a GC test. Among tested patients, ADI was not significantly associated with GC risk (all P-values >.05).

[CONCLUSION] Use of genomic testing was lower in patients living in areas with higher levels of social disadvantage, as well as patients of Hispanic ethnicity. These findings highlight demographic differences in the use of discretionary risk assessment tools for PCa.