Investigators have found that nearly 50% of women diagnosed with ovarian cancer may not be receiving the genetic testing that could help guide their treatment and potentially improve outcomes, according to a recent report conducted by the Ovarian Cancer Research Alliance (OCRA) and Komodo Health. The findings highlighted persistent disparities in genetic testing access, particularly among women older than age 65 and those reliant on public health insurance.
Background
Genetic testing often plays a pivotal role in the management of ovarian cancer, particularly in identifying BRCA mutations and other genetic markers that can help guide treatment with precision therapies such as PARP inhibitors.
Testing for BRCA and other mutations was previously recommended only for women with a family history of ovarian cancer. However, since 2014, leading health organizations—including the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology—have recommended that all women diagnosed with ovarian cancer receive genetic counseling and be offered genetic testing.
Nonetheless, obstacles such as socioeconomic and health-care access disparities continue to disproportionately affect women older than age 65 and those who rely on public health insurance.
OCRA is a global organization dedicated to combating ovarian cancer by providing free genetic testing resources as well as advocating for increased funding for gynecologic cancer research and expanded Medicaid and Medicare coverage for genetic testing and treatment. The organization hopes to advance equitable care and improve outcomes among all women impacted by ovarian and gynecologic cancers.
Komodo Health is a health-care technology company that leverages an extensive database known as the Healthcare Map to analyze real-world patient journeys. The database includes de-identified patient-level data from more than 330 million patients. The company works to enable organizations to uncover meaningful insights that drive improvements in health-care access, equity, and outcomes.
Study Methods and Results
In this study, the investigators used data compiled by Komodo Health to analyze the receipt of genetic testing among about 421,000 women diagnosed with ovarian cancer between 2016 and 2023. The investigators discovered that 52% of the women received genetic testing, despite universal recommendations that all women with this disease be tested. This disparity in the receipt of a critical diagnostic tool may impact patient care.
The data also revealed gaps based on insurance coverage and age. For instance, women who had commercial insurance were 37% more likely to undergo genetic testing compared with those who had public insurance. On average, 62% of patients who had commercial insurance received genetic testing compared with 38% of Medicare fee-for-service beneficiaries and 40% of state Medicaid beneficiaries. Additionally, younger patients were tested at significantly higher rates than older patients, with pediatric patients tested more than twice as frequently as patients aged 65 and older.
Conclusions
The investigators emphasized that with no early-detection tests and prior research demonstrating that, in most cases, identifying ovarian cancer long before the emergence of symptoms may not improve mortality, providing patients with insights into their genetic risks could be critical to enabling them to take measures to prevent the development of ovarian cancer.
“These findings underscore the urgent need to ensure that every woman diagnosed with ovarian cancer has access to genetic testing and the potentially life-saving treatment insights it can provide,” underscored Audra Moran, President and Chief Executive Officer of OCRA. “The fact that nearly half of all [patients with] ovarian cancer are not being tested is unacceptable, and it is particularly concerning that older women and those on public insurance face the greatest barriers. At OCRA, we’re committed to … advocating for policies that improve access to care for all women facing ovarian and gynecologic cancers,” she concluded.
To view the full results from the OCRA and Komodo Health report, visit knowledge.komodohealth.com.
