Introduction Racial and ethnic disparities in genomic testing could exacerbate disparities in access to precision cancer therapies and survival—particularly in the context of lung cancer, where genomic testing has been recommended for the past decade. However, prior studies assessing disparities in genomic testing have yielded mixed results. Methods We conducted a systemic review to examine racial and ethnic disparities in the use of genomic testing among lung cancer patients in the U.S. Two comprehensive searches in PubMed, Embase, and Scopus were conducted (September 2022, May 2023). Original studies that assessed rates of genomic testing by race or ethnicity were included. Findings were narratively synthesized by outcome. Results The search yielded 2,739 unique records, resulting in 18 included studies. All but one study was limited to patients diagnosed with non-small cell lung cancer. Diagnosis years ranged from 2007-2022. Eleven of 18 studies found statistically significant differences in the likelihood of genomic testing by race or ethnicity; in seven of these studies, testing was lower among Black patients compared to White or Asian patients. However, many studies lacked adjustment for key covariates and included patients with unclear eligibility for testing. Conclusions A majority of studies, though not all, observed racial and ethnic disparities in the use of genomic testing among patients with lung cancer. Heterogeneity of study results throughout a period of changing clinical guidelines suggests that minoritized populations—Black patients in particular—have faced additional barriers to genomic testing, even if not universally observed at all institutions.

中文翻译：

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肺癌患者基因组检测中的种族和民族差异：系统评价

简介 基因组测试中的种族和民族差异可能会加剧获得精准癌症治疗和生存方面的差异，特别是在肺癌的背景下，在过去十年中一直建议进行基因组测试。然而，之前评估基因组测试差异的研究得出了不同的结果。方法 我们进行了系统综述，以检查美国肺癌患者使用基因组检测方面的种族和民族差异，并在 PubMed、Embase 和 Scopus 中进行了两次全面检索（2022 年 9 月、2023 年 5 月）。其中包括按种族或民族评估基因组检测率的原始研究。调查结果按结果进行叙述性综合。结果 检索产生了 2,739 条独特记录，从而纳入了 18 项研究。除一项研究外，所有研究均仅限于诊断为非小细胞肺癌的患者。诊断年份范围为2007年至2022年。 18 项研究中有 11 项发现，不同种族或族裔进行基因组检测的可能性存在统计学上的显着差异；在其中七项研究中，黑人患者的检测水平低于白人或亚洲患者。然而，许多研究缺乏对关键协变量的调整，并且纳入了测试资格不明确的患者。结论 大多数研究（尽管不是全部）观察到肺癌患者在使用基因组检测方面存在种族和民族差异。在临床指南不断变化的时期，研究结果的异质性表明，少数群体（尤其是黑人患者）在基因组检测方面面临着额外的障碍，即使并非在所有机构都普遍观察到。