Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA.
Harvard Medical School, Boston, MA.
JCO Oncol Pract. 2024 Nov;20(11):1515-1522. doi: 10.1200/OP.24.00131. Epub 2024 Nov 12.
Molecular prognostic and diagnostic tools allow for targeted cancer surveillance, prognostication, and treatment, and these assays have the potential to improve the lives of patients and their relatives. The impact of these advances, however, is not uniform across populations. Underserved communities frequently do not have the same level of access to novel assays, and the clinical application of these tools is often limited by disproportionate representation of White and European ancestry populations in foundational data, as well as limited diversity in clinical trials. In this review, we highlight major advances in clinical molecular assays, key areas of disparity, and contributing factors. We then list ongoing and future areas of intervention to improve access to and efficacy of molecular assays across populations, so that we as a community may work to improve equity at this critical area of cancer care.
分子预后和诊断工具可用于癌症的靶向监测、预后和治疗，这些检测方法有可能改善患者及其亲属的生活。然而，这些进展的影响在人群中并不均等。服务不足的社区通常无法获得新型检测方法，而且这些工具的临床应用常常受到基础数据中白人和欧洲血统人群不成比例的代表性以及临床试验中有限的多样性的限制。在这篇综述中，我们强调了临床分子检测的主要进展、主要差异领域和促成因素。然后，我们列出了当前和未来干预的领域，以改善人群中分子检测的可及性和效果，这样我们作为一个团体就可以努力在癌症治疗的这一关键领域改善公平性。
