专业指南建议对子宫内膜癌 (EC) 中的错配修复 (MMR)、p53 和聚合酶 epsilon (POLE) 状态进行分子分析。然而，美国的采用情况尚未有记录，也没有描述实施测试的障碍。在这项混合方法研究中，使用实施科学框架来开展定量调查。通过滚雪球抽样的方式联系了隶属于 NRG 肿瘤学项目的妇科肿瘤学家、肿瘤内科医生、放射肿瘤学家和病理学家，并在 2022 年至 2023 年期间接受了调查。一部分受访者接受了采访。进行了统计和主题分析。本次调查至少联系了 403 家 NRG 肿瘤学附属提供者，其中 107 家 (26.6%) 做出了回应。超过 90% 的受访者认为 POLE、MMR 和 p53 状态对于临床护理很重要。 MMR 和 p53 检测被认为很容易获得，但只有 24.2% 的受访者表示 POLE 检测中等或非常容易获得。与来自社区网站的受访者相比，来自学术网站的受访者表示更容易获得分子分类，并且认为分子分类更重要。在对 13 次定性访谈的主题分析中，成本问题被认为是测试的一大障碍。受访者表示希望获得前瞻性数据，以根据分类结果指导治疗选择。尽管建议将分子分类纳入标准病理报告，并且临床医生认为早期 EC 的分子分析很重要，但调查受访者指出了巨大的实施障碍。确定了社区肿瘤学和学术实践环境之间不同的实施挑战。需要制定策略来改善早期 EC 分子分类的公平获取。© 2024 美国癌症协会。本文由美国政府雇员撰写，他们的作品在美国属于公共领域。

Professional guidelines recommend molecular profiling for mismatch repair (MMR), p53, and polymerase epsilon (POLE) status in endometrial cancer (EC). However, adoption in the United States has not been documented, and barriers to the implementation of testing have not been described.In this mixed-methods study, implementation science frameworks were used to develop a quantitative survey. Gynecologic oncologists, medical oncologists, radiation oncologists, and pathologists affiliated with NRG Oncology programs were contacted through snowball sampling and were surveyed during 2022-2023. A subset of respondents was interviewed. Statistical and thematic analyses were performed.At least 403 NRG Oncology-affiliated providers were contacted for the survey, and 107 (26.6%) responded. Greater than 90% of respondents perceived POLE, MMR, and p53 status as important for clinical care. MMR and p53 tests were perceived as easy to obtain, but only 24.2% of respondents reported that POLE testing was moderately or very easy to obtain. Respondents from academic sites reported better access to molecular classification and perceived greater importance of molecular classification compared with respondents from community sites. In thematic analysis of 13 qualitative interviews, cost concerns were reported as large barriers to testing. Interviewees reported a desire for prospective data to guide treatment selection based on classification results.Although integrating molecular classification into standard pathologic reporting is recommended, and clinicians perceive molecular profiling in early stage EC as important, survey respondents noted significant implementation barriers. Implementation challenges that differ between community oncology and academic practice settings were identified. Strategies to improve equitable access to molecular classification of early stage EC are needed.© 2024 American Cancer Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.