Background
Disparities in health care remain a persistent challenge, particularly among racial and ethnic minorities, who often report lower satisfaction with their providers, limited continuity of care, and lower perceived quality of treatment. These groups are more likely to receive less empathetic responses, have greater difficulty establishing rapport with physicians, and are less frequently encouraged to participate in medical decision-making. In addition to these reported experiences, racial and ethnic disparities in cancer outcomes—such as survival—have been widely documented, with Black and Hispanic patients consistently experiencing worse prognoses across multiple cancer types.
In response, medical practice has increasingly emphasized relationship-centered care, prioritizing cultural competence, trust, and effective communication, particularly for physicians treating diverse patient populations. Similarly, strong patient–physician relationships, built on mutual understanding and shared social or cultural backgrounds, have been linked to improved health care experiences and outcomes. Structural factors such as shared racial, ethnic, or gender identity, or concordance, between patients and providers may further influence engagement in care and adherence to medical recommendations.
Although prior studies have examined the impact of provider–patient concordance on treatment adherence, less is known about its role in biomarker testing adherence, which is critical for disease monitoring in chronic myeloid leukemia (CML). Longitudinal BCR::ABL1 testing is essential in CML management, because fluctuations in biomarker levels can indicate an increased risk of relapse and provide oncologists with critical information to adjust treatment strategies. Although oncologists primarily oversee biomarker testing, primary care physicians (PCPs) play an important and often underrecognized role in cancer care, particularly in survivorship and long-term disease monitoring. Nearly all US cancer survivors transition back to primary care, and regular PCP engagement has been associated with improved adherence to screenings, better care coordination, and even lower cancer-specific mortality. In integrated health care settings, where PCPs have access to shared medical records, they are well positioned to reinforce adherence to recommended testing during routine visits. Although biomarker testing is not a traditional preventive screening measure, PCPs frequently serve as key points of contact for ensuring patients stay up to date on necessary follow-up tests, including molecular monitoring critical to managing chronic cancers like CML.
This study examines the association between patient–PCP concordance and biomarker testing adherence, providing insight into how continuity in primary care relationships may contribute to adherence to guideline-recommended testing. As a secondary analysis, we also evaluate oncologist-patient concordance to compare its relative influence on adherence. Together, these analyses highlight the distinct role of PCPs—and the broader care team—in supporting long-term disease surveillance and engagement with molecular monitoring protocols.
The full study can be viewed at the Journal of the National Comprehensive Cancer Network.
Montano-Campos JF, Shared identity and patient care: Adherence to guideline-recommended biomarker testing in chronic myeloid leukemia. JNCCN. Volume 24, Issue 3, https://doi.org/10.6004/jnccn.2025.7109.
