{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:25:50Z","timestamp":1787009150233,"version":"build-2736575974"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000892","name":"Prostate Cancer Foundation","doi-asserted-by":"publisher","award":["#23YOUN25"],"award-info":[{"award-number":["#23YOUN25"]}],"id":[{"id":"10.13039\/100000892","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004324","name":"Astellas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004324","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010477","name":"Intuitive Surgical","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010477","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005565","name":"Janssen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005565","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Pfizer Global Medical"},{"name":"Health Disparity Research"},{"name":"Bruce A Beal"},{"name":"Robert L Beal"},{"DOI":"10.13039\/100000892","name":"Prostate Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000892","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["#23YOUN25"],"award-info":[{"award-number":["#23YOUN25"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Personalized therapeutic approaches for localized prostate cancer have evolved significantly, with tissue-based biomarker tests supplementing traditional risk stratification tools. However, national testing patterns and geographic variability remain limited a decade after coverage implementation. We aimed to assess current nationwide utilization and urban-rural differences in tissue-based biomarker testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using full Medicare claims data, we retrospectively identified patients with newly diagnosed prostate cancer and tissue-based biomarker testing claims from 2019 to 2023. Patients' county of residence was categorized as metro, urban, or rural. Regional testing rates were further assessed across hospital referral regions. A multivariable logistic regression model was performed to assess the effect of residence on test receipt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our final cohort included 749\u00a0202 patients, of whom 79.5% lived in metro, 11.4% in urban and 8.00% in rural counties. Overall, 86\u00a0908 (11.6%) patients underwent tissue-based biomarker tests. Hospital referral region-level testing rates ranged from 2.4% to 42.7%. Rural patients were 18% less likely to undergo testing compared to metro patients (odds ratio [OR] 0.82, 95% CI = 0.73 to 0.91). Independently, the odds of undergoing testing were lower among Black (OR 0.82, 95% CI = 0.77 to 0.88) and Hispanic patients (OR 0.80, 95% CI = 0.73 to 0.88) compared to White patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reveals high geographic variability in tissue-based biomarker testing for prostate cancer. Further, Black and Hispanic patients were less likely to receive testing. Our findings highlight regional practice variation in the use of advanced, not routinely recommended tests and underscore the need to minimize disparities in diagnostic access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkaf051","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T08:21:48Z","timestamp":1747297308000},"source":"Crossref","is-referenced-by-count":4,"title":["Disparities in tissue-based biomarker testing among US Medicare beneficiaries with prostate cancer"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3962-6049","authenticated-orcid":false,"given":"Stephan M","family":"Korn","sequence":"first","affiliation":[{"name":"Department of Urology, Medical University of Vienna , Vienna,","place":["Austria"]},{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United 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Graz,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6601-1244","authenticated-orcid":false,"given":"Andrea","family":"Piccolini","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United States"]},{"name":"Department of Urology, Humanitas Clinical and Research Hospital , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6740-4005","authenticated-orcid":false,"given":"Klara K","family":"Pohl","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United States"]},{"name":"Department of Urology, Medical University of Graz , Graz,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Lipsitz","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-4822","authenticated-orcid":false,"given":"Jianyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9446-7781","authenticated-orcid":false,"given":"Adam S","family":"Kibel","sequence":"additional","affiliation":[{"name":"Department of Urology, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["United 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