Abstract A008: Empowering equity: Accelerated germline genetic testing for pancreatic ductal adenocarcinoma erodes delays, democratizes access, and mitigates disparity
Authors: Zou Xianghui , Sidiqi Baho , Chen Ellen , Kauff Noah , King Daniel 
Published: January 2024

Background: Germline genetic testing is recommended for patients with pancreatic ductal adenocarcinoma (PDAC) as is pre-diagnostic testing for those with a significant family history. Our previous study identified delays in germline testing for socioeconomically disadvantaged patients. We aimed to compare delays before and after implementing recommendations for same-day germline assessment through a recent data analysis. Methods: Using an IRB-approved protocol, PDAC patients were identified from Jan 2022 to Dec 2022 in our EMR system. Median income was estimated by zip code. Delays were calculated as the difference between diagnosis date and germline test date. Social work needs were assessed through EMR review. Results: An additional 100 patients were found to have germline genetic tests performed. Compared to our previous study of 135 patients with a median delay of 27 days (d) in obtaining germline testing, our recent data showed a median delay of 15d (p=0.0215). In our previous study, 50 out of 135 patients (37.04%) received germline genetic testing within two weeks of their diagnosis of pancreatic cancer, whereas our recent data showed that 49 out of 100 patients (49.00%) received germline genetic testing within two weeks of their diagnosis of pancreatic cancer (Chi square=3.372, p=0.0663), a 32% relative increase. Our previous study identified a negative correlation between median income and delays in germline testing (r=-0.2578, p=0.0025). However, this correlation became non-significant in our recent data capture (r=0.0419, p=0.6802). Compared to our previous study in underserved minority (UM) patients (African American and Hispanic), our recent data showed a significant decrease in the delays for testing in UM patients (66d vs 19d, p=0.0041). We did not identify a difference in delays for testing between UM and not UM patients in the recent dataset (UM: 19d vs not UM: 15d, p=0.8075). In addition, compared to our previous study in patients with social work (SW) needs, our recent data showed a significant decrease in the delays for patients with SW needs (104d vs 13d, p=0.0004). We did not detect a significant difference between patients with SW needs and without SW needs in our recent data (SW: 13d vs no SW: 15d, p=0.8041).Conclusion: Our recent analysis showed a significant decrease in delays of germline testing due to the fact that more patients received prompt testing after their diagnosis of pancreatic cancer. Unlike our previous study, socioeconomically disadvantaged patients and those with social work needs no longer experienced significant delays in testing. Our previous publication has raised awareness in our institution, and we plan to initiate germline testing during patients' first visit by providing introductory videos to increase understanding of consent, encourage participation, and further reduce delays.

Citation Format: Xianghui Zou, Baho Sidiqi, Ellen Chen, Noah Kauff, Daniel King. Empowering equity: Accelerated germline genetic testing for pancreatic ductal adenocarcinoma erodes delays, democratizes access, and mitigates disparity [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A008.