Socioeconomic disparities in access to biomarker testing for gastrointestinal cancers: A nationwide patient-reported outcomes analysis.

e23261 Background: Recent advancements in biomarker technology, in conjunction with growing patient awareness, are notably transforming cancer care in the United States. However, access remains stratified by geography and local resources or support. To address these disparities, the GI Cancers Alliance launched a comprehensive initiative, designed to both increase patient education on the critical role of biomarkers in personalized treatment plans, and rigorously identify systemic barriers impeding access within the gastrointestinal (GI) cancer community. Methods: This 12-month, mixed-methods patient-reported outcomes (PRO) study analyzed a group of 1,224 patients across all GI cancer indications. Methodologies included quantitative in-person and online surveys, concurrently with qualitative individual interviews, focus groups, and advisory boards. To ensure a balanced nationwide dataset, participation extended across diverse care settings, including the VA National Oncology Program (16%), NCI Centers of Excellence (12%), academic (14%), regional (18%), local community oncology centers (19%), and Federally Qualified Health Centers (21%). Results: The analysis exposed crucial health disparities and communication deficits. Only 49% of patients reported that their provider explained biomarker testing. Conversely, 51% received no such information; importantly, 91% of this uninformed subgroup resided in under-resourced areas. Educational gaps were similarly shown through the collected data: 59% of patients reported lacking an understanding of biomarker utility, with 87% of these individuals receiving care in underserved regions. Additional patient-reported barriers included financial costs (71%), insurance denials or protracted appeals (67%), laboratory processing delays (53%), and operational inefficiencies (38%). After the implementation of targeted biomarker education workshops, engagement metrics improved: inquiries to patient navigators increased by 72%, and 88% of participants affirmed their intent to initiate biomarker testing discussions with their clinicians. Conclusions: At present, substantial socioeconomic and communication barriers restrict the equitable access of precision medicine in gastrointestinal oncology. While financial and systemic obstacles are widespread, this study demonstrates that targeted patient education is the foundation for patient empowerment. To narrow these education gaps, we are expanding the "Test Your Biomarkers" program and integrating dedicated Biomarker Patient Navigators. These actions are essential to provide gastrointestinal cancer patients with the resources needed for shared decision-making, and to eliminate zip-code-dependent variations in cancer care outcomes.