SDOH Drive Disparities in NGS Access Across Cancers

Why It Matters

NGS guides targeted therapies that improve survival, so unequal access deepens outcome gaps and threatens equity in cancer care. Addressing these SDOH‑driven barriers is essential for both clinical effectiveness and health‑system cost efficiency.

Key Takeaways

• Low SES patients experience longer NGS wait times.
• Hispanic and Black patients have reduced NGS uptake.
• Medicaid/Medicare coverage delays genomic testing.
• Academic centers show slower NGS access than community.
• NGS incidence rose 2018‑2022 but remains below 80%.

Pulse Analysis

Next‑generation sequencing has become a cornerstone of precision oncology, enabling clinicians to match patients with targeted therapies that can extend life expectancy. Yet, despite its clinical value, the study reveals that only about half of eligible patients with advanced lung or colorectal cancer received NGS within a year of diagnosis, and the rates are markedly lower for breast, prostate, and pancreatic cancers. This uneven adoption reflects broader systemic issues rather than technology limitations, underscoring the need for a health‑systemwide push to embed genomic profiling as a standard of care.

The analysis pinpoints several SDOH factors that systematically impede timely testing. Patients with low socioeconomic status, those identifying as Hispanic or non‑Hispanic Black, and individuals covered by Medicaid or Medicare experience longer intervals before NGS, often exceeding several months. Academic institutions, traditionally seen as hubs of innovation, paradoxically lag behind community practices in delivering rapid genomic testing, perhaps due to bureaucratic pathways or resource allocation. These disparities are consistent across tumor types, suggesting that structural barriers—such as insurance reimbursement policies, geographic access to testing facilities, and provider awareness—play a decisive role.

For policymakers and health‑system leaders, the findings signal an urgent call to action. Initiatives could include mandating coverage of NGS for all advanced cancers, incentivizing community oncology practices to adopt rapid testing protocols, and deploying targeted outreach programs in underserved neighborhoods. Moreover, integrating SDOH screening into electronic health records can flag high‑risk patients for expedited genomic work‑ups. By closing the NGS gap, the oncology community can ensure that the promise of precision medicine translates into equitable survival gains across the entire patient population.