Use of next-generation sequencing in advanced cancer has increased, yet access remains uneven across socioeconomic, racial, and insurance groups. Between 2018 and 2022, testing rates rose among patients with metastatic breast, prostate, non-small cell lung, colorectal, and pancreatic cancers. However, a significant portion of patients did not undergo this crucial testing.
Despite progress, significant disparities in the time to testing persist. Lower socioeconomic status and being Black or Hispanic were associated with longer delays in testing for various advanced cancers. Insurance status also played a role, with Medicare or government coverage linked to longer wait times for several cancer types.
These findings highlight that while next-generation sequencing adoption is improving, equitable access is incomplete. Delayed or absent genomic profiling can hinder timely identification of actionable alterations and limit the use of precision oncology strategies, underscoring the need for policy and educational efforts to close these access gaps.