{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:51:53Z","timestamp":1753883513810,"version":"3.41.2"},"reference-count":49,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>This study introduces an integrated approach using structured and unstructured data from an electronic health record to identify and characterize patient utilization of hereditary cancer genetic testing among patients with metastatic castration-resistant prostate cancer (mCRPC). Secondary objectives were to describe factors associated with the receipt of testing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>This retrospective cohort study included a cohort of Veterans diagnosed with mCRPC from January 2016 to December 2021. Receipt of genetic testing was identified using structured and unstructured data. Time to testing, age at testing, and testing rate were analyzed. Sociodemographic and clinical factors associated with receipt of hereditary cancer genetic testing were identified including race, marital status, rurality, Charlson comorbidity index (CCI), and genetic counseling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Among 9,703 Veterans with mCRPC who did not decline testing, 16% received genetic testing, with nearly half of the tests occurring in 2020-2021. Factors positively associated with genetic testing included receipt of genetic counseling (adjusted odds ratio [aOR], 11.07 [95% CI, 3.66 to 33.51]), enrollment in clinical trial (aOR, 7.42 [95% CI, 5.59 to 9.84]), and treatment at a Prostate Cancer Foundation-Veterans Affairs Center of Excellence (aOR, 1.43 [95% CI, 1.04 to 1.95]). Negative associations included older age (aOR, 0.95 [95% CI, 0.93 to 0.97]) and severe CCI score (aOR, 0.82 [95% CI, 0.71 to 0.94]). Trends revealed that time to testing decreased per diagnosis year while median age at testing increased per year.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Although testing rates are still suboptimal, they have increased steadily since 2016. Educating Veterans about the benefits of genetic testing may further improve testing rates.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/cci-24-00189","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T21:00:22Z","timestamp":1739221222000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Incorporating Structured and Unstructured Data Sources to Identify and Characterize Hereditary Cancer Testing Among Veterans With Metastatic Castration-Resistant Prostate Cancer"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8750-6720","authenticated-orcid":true,"given":"Danielle","family":"Candelieri-Surette","sequence":"first","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0730-431X","authenticated-orcid":true,"given":"Anna","family":"Hung","sequence":"additional","affiliation":[{"name":"Durham VA Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatai Y.","family":"Agiri","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9421-6432","authenticated-orcid":true,"given":"Mengke","family":"Hu","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth E.","family":"Hanchrow","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-0448","authenticated-orcid":true,"given":"Kyung Min","family":"Lee","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-8967","authenticated-orcid":true,"given":"Nai-Chung N.","family":"Chang","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Yin","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3982-781X","authenticated-orcid":true,"given":"Jeffrey W.","family":"Shevach","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, The Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiyan","family":"Li","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals, LP, Gaithersburg, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5216-7337","authenticated-orcid":true,"given":"Tyler J.","family":"Nelson","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6781-7873","authenticated-orcid":true,"given":"Anthony","family":"Gao","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M.","family":"Pridgen","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-5553","authenticated-orcid":true,"given":"Martin W.","family":"Schoen","sequence":"additional","affiliation":[{"name":"Medicine Service, St Louis Veterans Affairs Health Care System, Saint Louis, MO"},{"name":"Department of Internal Medicine, Division of Hematology\/Oncology, Saint Louis University School of Medicine, Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4898-3865","authenticated-orcid":true,"given":"Scott L.","family":"DuVall","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Ning","family":"Wong","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA"},{"name":"Division of Hematology\/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-2127","authenticated-orcid":true,"given":"Julie A.","family":"Lynch","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-5447","authenticated-orcid":true,"given":"Patrick R.","family":"Alba","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","first-page":"200","article-title":"Imaging and treatment recommendations in patients with castrate-resistant prostate cancer","volume":"19","author":"Albala DM","year":"2017","unstructured":"Albala DM: Imaging and treatment recommendations in patients with castrate-resistant prostate cancer. Rev Urol 19:200-202, 2017","journal-title":"Rev Urol"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2019.09.027"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.2246"},{"key":"e_1_3_7_5_2","first-page":"S32","article-title":"Prostate Cancer Foundation-Department of Veterans Affairs partnership: A model of public-private collaboration to advance treatment and care of invasive cancers","volume":"37","author":"Levine R","year":"2020","unstructured":"Levine R, Ekanayake RN, Martin AC, et al: Prostate Cancer Foundation-Department of Veterans Affairs partnership: A model of public-private collaboration to advance treatment and care of invasive cancers. Fed Pract 37:S32-S37, 2020 (suppl 4)","journal-title":"Fed Pract"},{"key":"e_1_3_7_6_2","unstructured":"Reference deleted"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0023"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-022-00580-7"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.08.079"},{"key":"e_1_3_7_10_2","article-title":"Inherited mutations in men undergoing multigene panel testing for prostate cancer: Emerging implications for personalized prostate cancer genetic evaluation","author":"Giri VN","unstructured":"Giri VN, Obeid E, Gross L, et al: Inherited mutations in men undergoing multigene panel testing for prostate cancer: Emerging implications for personalized prostate cancer genetic evaluation. JCO Precis Oncol 10.1200\/PO.16.00039","journal-title":"JCO Precis Oncol"},{"key":"e_1_3_7_11_2","article-title":"Pathogenic germline DNA repair gene and HOXB13 mutations in men with metastatic prostate cancer","author":"Boyle JL","unstructured":"Boyle JL, Hahn AW, Kapron AL, et al: Pathogenic germline DNA repair gene and HOXB13 mutations in men with metastatic prostate cancer. JCO Precis Oncol 10.1200\/PO.19.00284","journal-title":"JCO Precis Oncol"},{"key":"e_1_3_7_12_2","article-title":"Contribution of inherited DNA-repair gene mutations to hormone-sensitive and castrate-resistant metastatic prostate cancer and implications for clinical outcome","author":"Yadav S","unstructured":"Yadav S, Hart SN, Hu C, et al: Contribution of inherited DNA-repair gene mutations to hormone-sensitive and castrate-resistant metastatic prostate cancer and implications for clinical outcome. JCO Precis Oncol 10.1200\/PO.19.00067","journal-title":"JCO Precis Oncol"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2019.12.003"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.09.021"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0495"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00358"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603144"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23010348"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.28015"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-022-00609-3"},{"key":"e_1_3_7_21_2","unstructured":"U.S. Food and Drug Administration: FDA approves olaparib for HRR gene-mutated metastatic castration-resistant prostate cancer 2020. https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-approves-olaparib-hrr-gene-mutated-metastatic-castration-resistant-prostate-cancer"},{"key":"e_1_3_7_22_2","unstructured":"U.S. Food and Drug Administration: FDA grants accelerated approval to rucaparib for BRCA-mutated metastatic castration-resistant prostate cancer 2020. https:\/\/www.fda.gov\/drugs\/resources-information-approved-drugs\/fda-grants-accelerated-approval-rucaparib-brca-mutated-metastatic-castration-resistant-prostate"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911440"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2022485"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgc4.1731"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocv065"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-020-0783-8"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006910"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.02.013"},{"key":"e_1_3_7_30_2","unstructured":"de Lartigue J: Blurring the lines between germline and somatic mutations in cancer. Oncology Live 18 2017. https:\/\/www.onclive.com\/view\/blurring-the-lines-between-germline-and-somatic-mutations-in-cancer"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-016-0371-3"},{"key":"e_1_3_7_32_2","article-title":"Development and validation of a tool to identify patients diagnosed with castration-resistant prostate cancer","author":"Candelieri-Surette D","unstructured":"Candelieri-Surette D, Hung A, Lynch JA, et al: Development and validation of a tool to identify patients diagnosed with castration-resistant prostate cancer. JCO Clin Cancer Inform 10.1200\/CCI.23.00085","journal-title":"JCO Clin Cancer Inform"},{"key":"e_1_3_7_33_2","unstructured":"U.S. Department of Veterans Affairs:: VA priority groups 2024. https:\/\/www.va.gov\/health-care\/eligibility\/priority-groups\/"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_7_35_2","volume-title":"Facilities Staffing Requirements for the Veterans Health Administration: Resource Planning and Methodology for the Future","author":"National Academies of Sciences, Engineering, and Medicine","year":"2020","unstructured":"National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Human-Systems Integration; et al: Facilities Staffing Requirements for the Veterans Health Administration: Resource Planning and Methodology for the Future. Washington, DC, National Academies Press, 2020"},{"key":"e_1_3_7_36_2","first-page":"152","volume-title":"Geographic Areas Reference Manual","author":"Geography Division","year":"1994","unstructured":"Geography Division: Statistical groupings of States and counties, in Torrieri N, Davis J, Gregory E (eds): Geographic Areas Reference Manual. Suitland, MD, Bureau of the Census, 1994, pp 152-177"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302202"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2023.03.001"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.9526"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2021-0153"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34208"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2021.100327"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2016.08.018"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.7257"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyad044"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.7105"},{"key":"e_1_3_7_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2022.100588"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-018-0417-6"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2008.09.003"},{"key":"e_1_3_7_50_2","unstructured":"M21-1 adjudication procedures manual. U.S. Department of Veterans Affairs. https:\/\/www.knowva.ebenefits.va.gov\/system\/templates\/selfservice\/va_ssnew\/help\/customer\/locale\/en-US\/portal\/554400000001018\/content\/554400000073398\/M21-1-Adjudication-Procedures-Manual-Table-of-Contents"}],"container-title":["JCO Clinical Cancer Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/CCI-24-00189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T21:00:28Z","timestamp":1739221228000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/CCI-24-00189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":49,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1200\/CCI-24-00189"],"URL":"https:\/\/doi.org\/10.1200\/cci-24-00189","relation":{},"ISSN":["2473-4276"],"issn-type":[{"type":"electronic","value":"2473-4276"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2400189"}}