Racial, ethnic minorities less likely to participate in cancer clinical trials
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Key takeaways:
- Patients with cancer who speak Chinese are less likely to participate in clinical trials than those who speak English.
- Side effects are the main reason individuals indicated they did not wish to participate in a clinical trial.
Members of racial and ethnic minority groups are significantly less likely to participate in cancer clinical trials than their non-Hispanic white counterparts, study results showed.
Such a discrepancy in participation — according to data presented at the American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved — has contributed toward disparities in various areas of health care, such as cancer diagnosis and treatment.
“There’s currently a lack of representation in clinical trials. Our trials do not show the full range of people who are afflicted by cancer and therefore are not fully informing our treatments,” Amy L. Shaver, PhD, PharmD, MPH, a postdoctoral research fellow at Thomas Jefferson University, told Healio. “We need to understand how to better attract and retain a more representative sample of people so that the care we deliver is best suited to the people who it is delivered to.”
Background and methodology
Approximately 6% of patients with cancer in the United States participate in clinical trials, according to study investigators. Researchers at Sidney Kimmel Cancer Center conducted a cross-sectional study to analyze the impact of race and ethnicity on willingness to participate in clinical trials.
Respondents (n = 2,744; 57.8% white) resided in the cancer center’s catchment area, which included Philadelphia, Delaware, Bucks and Montgomery Counties in Pennsylvania and Camden, Burlington and Gloucester Counties in New Jersey, with responses taken from July to August 2022.
Survey questions administered in English, Spanish and Chinese included reasons for or against willingness to participate in clinical trials, lifestyle behaviors, cancer screening frequency, cancer attitudes or beliefs, health literacy and numeracy.
Researchers weighed frequency counts against population totals from the American Community Survey; received responses included English (80.1%), Spanish (13.2%) and Chinese (6.7%).
Results
A weighted sample represented the 3,889,048 residents of the catchment area.
Researchers noted that 69.8% of respondents stated willingness to participate in clinical trials.
However, respondents who used Chinese to answer appeared 40% less likely than those answering in English to indicate future participation in a clinical trial (OR = 0.6). Likewise, both Hispanic (OR = 0.67) and non-Hispanic Black (OR = 0.68) respondents appeared less likely to participate compared with non-Hispanic white individuals.
Respondents noted side effects (25.6%) as the most common reason they lacked willingness to participate in a clinical trial, whereas 17% viewed clinical trials as “experiments,” according to researchers.
Respondents who reported a high level of discrimination appeared 48% more likely to participate in a clinical trial than individuals who reported low levels of discrimination (P = .02).
Next steps
“For us, it was great to find out that almost 70% of respondents said they would participate in a future trial,” Shaver told Healio.
“However, there is still more to learn about the roughly 30% who were unwilling to do so — about how to best address their concerns,” she added. “This may be best addressed in small focus groups or in a qualitative study where we conduct interviews and collect text, video, etc., to better understand the catchment members’ opinions and experiences and incorporate that into planning.”
References:
- Racial and ethnic minorities may be less willing to participate in clinical trials (press release). Available at: https://www.aacr.org/about-the-aacr/newsroom/news-releases/racial-and-ethnic-minorities-may-be-less-willing-than-others-to-participate-in-clinical-trials. Published Sept. 29, 2023. Accessed Sept. 29, 2023.
- Shaver AL, et al. Factors associated with willingness to participate in future clinical trials. Presented at: AACR Conference on the Science of Cancer Disparities in Racial/Ethnic Minorities and the Medically Underserved; Sept. 29-Oct. 2, 2023; Orlando.
Collapse
Shaver AL, et al. Factors associated with willingness to participate in future clinical trials. Presented at: AACR Conference on the Science of Cancer Disparities in Racial/Ethnic Minorities and the Medically Underserved; Sept. 29-Oct. 2, 2023; Orlando.
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