--- title: "Diffusion of gene expression profiling in breast cancer pts. | Sutter Health" description: "Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients." url: "https://www.sutterhealth.org/research/publications/diffusion-gene-expression-profiling-breast-cancer-1055312821" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Diffusion of gene expression profiling in breast cancer pts. # Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality. Ponce NA, Ko M, Liang SY, Armstrong J, Toscano M, Chanfreau-Coffinier C, & Haas JS. _Health Aff (Millwood). 2015 Apr 1;34(4):609-15. doi: 10.1377/hlthaff.2014.1013._ 2015-04-01 ## Abstract With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. Gene expression profiling is a potentially cost-effective innovation that guides chemotherapy decisions in early-stage breast cancer, but adoption has been uneven across the United States. Using a sample of commercially insured women, we evaluated whether income inequality in metropolitan areas was associated with receipt of gene expression profiling during its initial diffusion in 2006-07. In areas with high income inequality, gene expression profiling receipt was higher than elsewhere, but it was associated with a 10.6-percentage-point gap between high- and low-income women. In areas with low rates of income inequality, gene expression profiling receipt was lower, with no significant differences by income. Even among insured women, income inequality may indirectly shape diffusion of gene expression profiling, with benefits accruing to the highest-income patients in the most unequal places. Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/25847643) ![Su-Ying Liang, Ph.D.](https://dyn.mktgcdn.com/p/cRIUee_GK3HEL1Wq8svqoUApvABjlwVVA-KUHVGzuNw/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Su-Ying Liang, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Genetics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Genetics%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.](https://www.sutterhealth.org/research/publications/characteristics-cancer-screening-asian-american-1055312854) Thompson CA, Gomez SL, Chan A, Chan JK, McClellan SR, Chung S, Olson C, Nimbal V, Palaniappan L. Cancer Epidemiol Biomarkers Prev. 23(11):2208-17. doi: 10.1158/1055-9965.EPI-14-0487. 2014 Nov 01 - Publication ### [The centralization of robotic surgery in high-volume centers for endometrial cancer patients--a study of 6560 cases in the U.S.](https://www.sutterhealth.org/research/publications/central-robotic-surery-centers-endometrial-cancer-1055312938) Chan JK, Gardner AB, Taylor K, Blansit K, Thompson CA, Brooks R, Yu X, Kapp DS. Gynecol Oncol. 2015 Jul;138(1):128-32. doi: 10.1016/j.ygyno.2015.04.031. Epub 2015 Apr 28. 2015 Jul 01 - Publication ### [Genomic testing & therapies for breast cancer in clinical practice.](https://www.sutterhealth.org/research/publications/genomic-testing-therapies-for-breast-cancer-1055312617) Haas JS, Phillips KA, Liang SY, Hassett MJ, Keohane C, Elkin EB, Armstrong J, Toscano M. J Oncol Pract. 7(3 Suppl):e1s-7s. doi: 10.1200/JOP.2011.000299 2011 May 01 - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/risk-benefit-contralateral-prophylactic-mastectomy-1055312871) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. pii: 1049732314557085. \[Epub ahead of print\] 2014 Nov 04 - Publication ### [Physicians' perceptions of shared decision-making behaviours: a qualitative study demonstrating the continued chasm between aspirations and clinical practice.](https://www.sutterhealth.org/research/publications/doctors-perceptions-shared-dec-making-behs-1055312533) Zeuner R, Frosch DL, Kuzemchak MD, Politi MC. Health Expect. 18(6):2465-76. doi: 10.1111/hex.12216. Epub 2014 Jun 17. 2015 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/diffusion-gene-expression-profiling-breast-cancer-1055312821#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Diffusion of gene expression profiling in breast cancer pts."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/diffusion-gene-expression-profiling-breast-cancer-1055312821#medicalscholarlyarticle","name":"Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.","headline":"Diffusion of gene expression profiling in breast cancer pts.","abstract":"With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. 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