Expanding Molecular Testing Access to Reduce Rural-Urban Disparities in Advanced NSCLC

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Among 8259 older Medicare beneficiaries with advanced NSCLC in rural counties, 35.9% received molecular testing from 2014 through 2019.
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Testing increased from 18% within 30 days of diagnosis to 30% within 60 days and 36% within 180 days.
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Testing was less common among older patients, patients with dual Medicare and Medicaid coverage, and patients with squamous histology.
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Current ASCO guidelines advise validated broad multigene testing using tissue and/or blood, with biomarker results available when treatment decisions are made.
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Equity measures should assess whether comprehensive molecular results are available before treatment and inform appropriate molecularly guided care.

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