One-quarter of oncologists do not talk costs with their cancer patients

Approximately 25% of oncologists who discuss clinical genomic testing with their patients fail to mention the costs associated with the analysis and related treatments.

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Genomic testing features heavily in the clinical diagnosis, treatment and management of many cancer forms. The results of new, American Cancer Society (NY, USA)-led study demonstrate that almost one-quarter of oncologists fail to mention test costs when discussing clinical genomic testing with patients.  

Genomic testing can be critical for determining which treatments may be more efficacious for certain individuals, however, the analysis can be costly and may not be covered by individuals’ health insurance.

In the USA, the costs associated with cancer care have been rising in recent years; of particular concern, are patients’ rising out-of-pocket costs for their treatments. This study sought to determine the frequency of discussions between oncologists and cancer patients about the potential costs of genomic testing and related treatments.

In the study, researchers employed data from the 2017 National Survey of Precision Medicine in Cancer Treatment – a survey promoted and sponsored by the National Cancer Institute, the National Human Genomic Research Institute (both MD, USA) and the American Cancer Society (NY, USA). Researchers identified 1220 oncologists who testified to discussing genomic testing with their cancer patients.

26.3% of participating oncologists reported only ‘sometimes’ discussing the potential costs of genomic testing and its associated treatments with patients. 23.7% of oncologists reported ‘never’ or ‘rarely’ discussing these costs with patients in the clinics.

Adjusted study analysis revealed that oncologists who had specialized training in genomic testing, or routinely worked with electronic medical record alerts for promoting genomic testing, were more than twice as likely to have cost discussions with their patients.

Oncologists were also more likely to discuss the costs of genomic testing and related treatments with their patients if they employed next-generation sequencing tests, had large patient volumes or had higher proportions of Medicaid-insured patients in their practices.

In the study, the authors concluded: “In the context of rising costs of cancer care, interventions targeting modifiable physician and practice factors may help increase the frequency of physician-patient cost discussions, contributing to more informed patient decisions and higher-quality cancer care.”


Yabroff KR, Zhao J, de Moor JS et al. Factors associated with oncologist discussions of the costs of genomic testing and related treatments. JNCI. doi:10.1093/jnci/djz173 (2019) (Epub ahead of print);

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Ilana Landau

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