Racial Variation in the Uptake of Oncotype DX Testing for Early-Stage XXXX .

@entity5 @entity1 @entity172 @entity0
PURPOSE: Oncotype DX (ODX) is a @entity5 gene-profiling test that aids in adjuvant chemotherapy decision-making. ODX has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in @entity5 care quality may persist or worsen. We examined racial disparities in ODX testing uptake. METHODS: We used data from the Carolina @entity0 Study, phase III, a longitudinal, population-based study of 2,998 North Carolina @entity1 who received a diagnosis of @entity0 between 2008 and 2014. Our primary analysis used modified Poisson regression to determine the association between race and whether ODX testing was ordered among two strata: node-negative and @entity0 . RESULTS: A total of 1,468 @entity1 with @entity172 receptor-positive, @entity1 epidermal growth factor receptor-2-negative, stage I or II @entity0 met inclusion criteria. Black @entity1 had higher-grade and larger @entity5 , more comorbidities, younger age at diagnosis, and lower socioeconomic status than non-black @entity1 . Overall, 42% of @entity1 had ODX test results in their pathology reports. Compared with those who did not receive ODX testing, @entity1 who received ODX testing tended to be younger and have medium @entity5 size and grade. Our regression analyses indicated no racial disparities in ODX uptake among node-negative @entity1 . However, racial differences were detected among node-positive @entity1 , with black @entity1 being 46% less likely to receive ODX testing than non-black @entity1 (adjusted relative risk, 0.54; 95% CI, 0.35 to 0.84; P = .006). CONCLUSION: We did not find racial disparities in ODX testing for node-negative @entity1 for whom ODX testing is guideline recommended and widely covered by insurers. However, our findings suggest that a newer, non-guideline-concordant application of ODX testing for @entity0 was accessed less by black @entity1 than by non-black @entity1 , reflecting more guideline concordant care among black @entity1 .
