Main Session
Sep
29
PQA 06 - Genitourinary Cancer, Gynecological Cancer, and Health Care Access and Engagement
Presenter(s)
Mathew Lin, BS - Dartmouth Geisel School of Medicine, Lebanon, NH
M. Lin1, N. S. Kapadia2,3, and J. B. Yu2,3; 1Dartmouth Medical School, Hanover, NH, 2Geisel School of Medicine at Dartmouth, Hannover, NH, 3Department of Radiation Oncology & Applied Sciences, Dartmouth Cancer Center, Lebanon, NH
Purpose/Objective(s):
The Decipher Genomic Classifier (GC) score is a 22-gene expression test that correlates with aggressive prostate cancer. Given the quantitative and objective nature of the GC score, it is a useful tool for measuring potential differences in disease presentation and aggressiveness by patient age, race, practice setting (academic vs. community) and practice rurality. Our study aims to clarify the trends in GC scores across these 4 variables.Materials/Methods:
Our cohort was derived from the NIH SEER Decipher Prostate Genomic Classifier Database and included patients with a numerically reported GC score (n=8,796). If patients had more than 1 GC score, then the first GC score was used for analysis as the presenting score. Patients were stratified by age (<50, 50-59, 60-69, 70-79, 80+), race (White, Black, Other), setting, and rurality. Kruskal-Wallis was used to compare GC scores for age and race. Patients were excluded from analysis of racial identification if it was Unknown (n=295). Wilcoxon rank-sum was used to compare GC scores for practice setting and rurality. For multivariate analysis, we estimated marginal means using the emmeans R package to compare race, practice setting and rurality, adjusting for age category.Results:
On univariate analysis, median GC scores significantly increased with age (<50: 0.46, 50-59: 0.50, 60-69: 0.54, 70-79: 0.56, 80+: 0.58, p<0.01). There were significant differences in median GC by practice (Academic: 0.55, Community: 0.47, p<0.01) and rurality (Rural: 0.56, Urban: 0.54, p<0.01) setting, but not by race (White: 0.54, Black: 0.54, Other: 0.54, p>0.05). Differences in age-adjusted estimated marginal means by practice and geographic setting remained significant (Rural: 0.56, Urban: 0.53, p<0.01; Academic: 0.54, Community: 0.47, p<0.01). Differences in age-adjusted estimated marginal means by race remained insignificant (White: 0.53, Black: 0.54, Other: 0.53, p>0.05).Conclusion:
Our findings demonstrate a significant difference in GC score between age groups, practice and geographic settings, but not by race. Our findings imply that older prostate cancer patients at academic and rurally located centers seem to present with more aggressive disease.