{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:47:57Z","timestamp":1785415677870,"version":"3.56.0"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001368","name":"V Foundation for Cancer Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001368","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00kbbk236","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Genomic testing is a key component of precision oncology; however, Black patients receive genomic testing at lower rates. The purpose of this qualitative study was to identify individual and health system drivers of genomic testing disparities at a National Cancer Institute-designated comprehensive cancer center. We conducted interviews with 15 oncology providers and 11 Black cancer patients between September 2023 and October 2024. These patients were eligible for genomic testing based on National Comprehensive Cancer Network (NCCN) guidelines, being diagnosed within last 10 years (2014\u20132023), at least 18 years old, and English-speaking. Providers included oncologists and oncology patient navigators. Topics included motivators, barriers, and knowledge of genomic testing and factors influencing decision-making. The Penchansky and Thomas theoretical framework of healthcare access (e.g., availability, accessibility, accommodation, affordability, and acceptability) guided thematic analysis. Among patients eligible for genomic testing, most participants (n = 7) received genomic testing as part of their cancer treatment based on EMRs, however many patients (n = 7) could not recall discussing genomic testing with their oncologist. Most patients and all providers highlighted affordability as a challenge: patients were concerned about unexpected costs associated with testing, while providers were concerned about costs of matched molecular targeted therapy. Both patients and providers highlighted patient-centered communication to mitigate mistrust and promote patient engagement in care. Despite limited awareness, Black patients view genomic testing positively. Addressing multiple dimensions of access is key to improving system-level processes and ensuring that more patients benefit from lifesaving targeted therapy.<\/jats:p>","DOI":"10.3390\/curroncol33070413","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:43:34Z","timestamp":1783683814000},"page":"413","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Access to Guideline-Concordant Oncology Genomic Testing: A Qualitative Study of Black Cancer Patients and Oncology Providers"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2264-6390","authenticated-orcid":false,"given":"Andrea","family":"Thoumi","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadurshini","family":"Raveendran","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA"},{"name":"Global Pediatric Medicine, St. Jude Children\u2019s Research Hospital, Memphis, TN 38105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fish","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Gathings","sequence":"additional","affiliation":[{"name":"ETR Services, Raleigh, NC 27705, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4382-0708","authenticated-orcid":false,"given":"Emily","family":"Rosario","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1199-6336","authenticated-orcid":false,"given":"Shaun R.","family":"Jones","sequence":"additional","affiliation":[{"name":"UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA"},{"name":"Department of Epidemiology, Gillings School of Global Public Health at University of North Carolina (UNC) at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden B.","family":"Bosworth","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA"},{"name":"Center for Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, NC 27701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Sutton","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7579-1175","authenticated-orcid":false,"given":"John H.","family":"Strickler","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1412-3234","authenticated-orcid":false,"given":"Tomi","family":"Akinyemiju","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA"},{"name":"Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. 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