Study Finds Many Cancer Patients Not Receiving Genomic Tests That Could Guide Treatment

A study published in JAMA Network Open reveals that roughly half of patients diagnosed with one of five metastatic cancers receive genetic sequencing, leaving many without access to potentially life-saving targeted therapies that exploit specific tumor mutations. The research identifies significant disparities, with Black patients, Hispanic patients, low-income patients, and those covered by Medicare or Medicaid less likely to receive genomic testing. Despite advances in targeted therapies contributing to improved survival rates—the overall five-year cancer survival rate reaching 70% as of 2026 and metastatic cancer survival doubling since the 1960s—many advanced treatments remain unused because tumor mutations go unidentified. Experts emphasize that for advanced cancers, sequencing the tumor genome should be among the first diagnostic steps to guide personalized treatment decisions.

Gaps in genomic testing for cancer patients

• ▪Many cancer patients never receive genomic testing and never get the chance to know if they might have benefitted from newer, more targeted therapies
• ▪For most cancers in the JAMA Network Open study, roughly half of patients in the cohort received genetic sequencing
• ▪For some advanced cancers, sequencing the tumor genome should be one of the first steps patients and physicians take
• ▪A study published on Tuesday in JAMA Network Open examined how many patients diagnosed with one of five different metastatic cancers received genetic sequencing for the cancers

Disparities in access to genetic sequencing

• ▪Patients with low income were less likely to receive genetic sequencing for metastatic cancers according to the JAMA Network Open study

Role of genomic testing in targeted cancer therapies

• ▪Targeted cancer therapies work by exploiting key cancer mutations
• ▪The five-year survival rate for metastatic cancer has doubled since the 1960s
• ▪Advanced targeted cancer therapies are going unused because tumor mutations are not being identified
• ▪The overall five-year cancer survival rate has pushed up to 70% as of 2026
• ▪Advances in medicines and technologies like targeted therapies have contributed to improved cancer survival rates over the last few decades

Perspective of Healthcare equity advocates

• ▪The disparities in genomic testing access for Black, Hispanic, low-income, Medicare, and Medicaid patients represent systemic inequities in cancer care delivery
• ▪Unequal access to genomic testing perpetuates survival outcome gaps between privileged and disadvantaged cancer patient populations

Perspective of Oncologists and cancer treatment specialists

• ▪Genomic sequencing of metastatic tumors should be a standard first-line diagnostic step rather than an optional procedure
• ▪The failure to sequence tumor genomes prevents oncologists from matching patients with the most effective targeted therapies available

Perspective of Insurance payers and healthcare systems

• ▪Lower genomic testing rates among Medicare and Medicaid beneficiaries may reflect coverage limitations or reimbursement barriers within these insurance programs
• ▪Healthcare systems must balance the upfront costs of genomic testing against potential long-term benefits from more effective targeted cancer treatments