Background
One in five people in the United States lives in rural areas. This population faces a higher risk of disease and mortality compared to urban residents, including a greater risk of death from conditions such as cancer. Access to molecular medicine for tailoring cancer treatments to patients is a significant challenge.
The Hartford Health Care Cancer Institute at Charlotte Hungerford Hospital primarily serves two municipalities in Connecticut: Winsted, with approximately 6,500 residents, and Torrington, a larger city with 34,000 residents. This location caters to a rural, underserved, and socioeconomically diverse population.
Methods
We initiated a review of the medical charts of all patients treated for hematologic malignancies and solid tumors at our center over the past year, excluding benign cases. We examined the number of patients who underwent testing for tumor markers and molecular studies using techniques such as immunohistochemistry, fluorescence in situ hybridization, and next-generation sequencing. Testing included both a tertiary hospital and external multi-gene platform vendors like Foundation Medicine and Guardant Health.
Results
In a sample of 51 patients seen during the first three weeks of July 2023, 52.9% had testing done only at tertiary hospitals, while 47% had testing with both tertiary hospitals and external vendors. Of the patients, 3.92% did not have target mutations, and 27.45% did not have target treatment. Importantly, 72.5% had treatments modified based on target mutations, with 15.69% being hematologic malignancies and 84.3% solid tumors.
Conclusion
Our rural oncology center is committed to overcoming geographical and resource-related challenges to ensure equity in cancer care. We have implemented precision medicine to improve treatment efficacy and reduce side effects by tailoring therapies based on precision medicine. While the small sample size is a limitation of our study, we plan ongoing random cohort testing to assess the consistency of our patient care over time.