Genomic Testing Uptake Among Medicare Beneficiaries With Cancer

How did uptake of genomic testing among Medicare beneficiaries with common cancers change following Medicare’s national coverage determinations (NCDs) for next-generation sequencing (NGS)? In this cohort study of 391 151 Medicare beneficiaries with lung, breast, colorectal, prostate, or endometrial cancer from 2016 to 2023, overall genomic testing increased nearly 3-fold after NCD implementation. The largest shift toward NGS was observed among beneficiaries with lung cancer, whereas non-NGS testing was observed among beneficiaries with breast cancer. These findings suggest Medicare coverage decisions were associated with increased genomic testing, but uptake varied widely across cancer types, highlighting persistent gaps in access to testing needed for precision medicine.

Corresponding Author: So-Yeon Kang, PhD, MBA, MPH, Department of Health Management and Policy, Georgetown University School of Health, 3700 Reservoir Rd NW, Washington, DC 20007 (soyeon.kang@georgetown.edu).

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