Real-World Trends, Rural-Urban Differences, and Socioeconomic Disparities in Access to and Utilisation of Tumour Genomic Profiling within a Tasmanian Population
| Wednesday, August 13, 2025 |
| 2:41 PM - 2:47 PM |
| Ballroom 2 and 3 |
Overview
Dr Nicole Zeglinas
Speaker
Dr Nicole Zeglinas
Advanced Trainee
Peter MacCallum Cancer Centre
Real-World Trends, Rural-Urban Differences, and Socioeconomic Disparities in Access to and Utilisation of Tumour Genomic Profiling within a Tasmanian Population
Abstract
Background:
Next-generation sequencing (NGS) enables identification of actionable genomic alterations, facilitating precision oncology and improved outcomes for patients with advanced cancers. National programs such as Molecular Screening and Therapeutics (MoST) and the Cancer Screening Program (CaSP), coordinated by Omico, have broadened access to genomic testing across Australia. However, disparities in access and utilisation remain, particularly among rural and socioeconomically disadvantaged populations. Tasmania, with its small and widely dispersed population, presents a valuable case study for exploring barriers to equitable genomic care.
Methods:
A retrospective observational study was conducted on Tasmanian patients referred to MoST or CaSP between March 2017 and June 2024. Data collected included prevalence of genomic alterations, actionability of results (TOPOGRAPH Tier), access to matched therapy (based on rural and remoteness Modified Monash Model (MMM) classification) and reported barriers to matched therapy.
Results:
A total of 558 patients (median age 65; 53% female) were included. Most (67%) lived in regional areas, with the remainder from more rural or remote communities. Lung (17%) and colorectal (14%) cancers were most common. Of 499 successfully profiled tumours, 97% harboured at least one variant. TP53 (64%), KRAS (29%), and APC (21%) were most frequently altered. Molecular tumour board (MTB) recommendations were made for 79% of patients; 29% received Tier 1 or 2 recommendations. Only 95 patients (20%) received matched therapy, including 31 (6%) via clinical trials, with a quarter requiring interstate travel. Access to trials was disproportionately low in more remote regions. Reported barriers included clinical ineligibility and logistical challenges such as distance to trial centres.
Conclusions:
While genomic profiling yields high rates of actionable findings, real-world utilisation is limited by geographic and systemic barriers. Ensuring equitable access to testing and matched therapies, particularly for patients outside urban centres, remains a critical challenge for precision oncology in Tasmania.
Acknowledgements: Omico
Next-generation sequencing (NGS) enables identification of actionable genomic alterations, facilitating precision oncology and improved outcomes for patients with advanced cancers. National programs such as Molecular Screening and Therapeutics (MoST) and the Cancer Screening Program (CaSP), coordinated by Omico, have broadened access to genomic testing across Australia. However, disparities in access and utilisation remain, particularly among rural and socioeconomically disadvantaged populations. Tasmania, with its small and widely dispersed population, presents a valuable case study for exploring barriers to equitable genomic care.
Methods:
A retrospective observational study was conducted on Tasmanian patients referred to MoST or CaSP between March 2017 and June 2024. Data collected included prevalence of genomic alterations, actionability of results (TOPOGRAPH Tier), access to matched therapy (based on rural and remoteness Modified Monash Model (MMM) classification) and reported barriers to matched therapy.
Results:
A total of 558 patients (median age 65; 53% female) were included. Most (67%) lived in regional areas, with the remainder from more rural or remote communities. Lung (17%) and colorectal (14%) cancers were most common. Of 499 successfully profiled tumours, 97% harboured at least one variant. TP53 (64%), KRAS (29%), and APC (21%) were most frequently altered. Molecular tumour board (MTB) recommendations were made for 79% of patients; 29% received Tier 1 or 2 recommendations. Only 95 patients (20%) received matched therapy, including 31 (6%) via clinical trials, with a quarter requiring interstate travel. Access to trials was disproportionately low in more remote regions. Reported barriers included clinical ineligibility and logistical challenges such as distance to trial centres.
Conclusions:
While genomic profiling yields high rates of actionable findings, real-world utilisation is limited by geographic and systemic barriers. Ensuring equitable access to testing and matched therapies, particularly for patients outside urban centres, remains a critical challenge for precision oncology in Tasmania.
Acknowledgements: Omico
Biography
Nicole Zeglinas is a second-year Advanced Trainee in Medical Oncology, currently based at the Peter MacCallum Cancer Centre. She commenced specialty training at St Vincent’s Hospital Melbourne, followed by the Royal Hobart Hospital in 2024. Nicole has a particular interest in precision oncology and its evolving role in delivering personalised cancer care.
Session Chair
Jessica Smith
Medical Oncologist
Macquarie University Hospital
