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How current reporting practices may mask differences: A call for examining cancer-specific demographic enrollment

Hala T Borno1,2, Eric J Small1,2, Li Zhang3,2

  • 1University of California at San Francisco, Division of Hematology/Oncology, United States.

Contemporary Clinical Trials Communications
|December 25, 2019
PubMed
Abstract

Insights

Clinical trial diversity varies by cancer type. Older adults are overrepresented in prostate cancer trials but underrepresented in breast and colorectal cancer trials, highlighting the need for type-specific recruitment strategies.

Area of Science:

  • Oncology
  • Clinical Trials
  • Health Disparities

Background:

  • Lack of diversity in clinical trial participants is a persistent issue.
  • Variability in cancer treatment clinical trial recruitment by cancer type is understudied.
  • Understanding recruitment variability is crucial for optimizing institutional practices in specialized oncologic care.

Purpose of the Study:

  • To examine recruitment variability in cancer treatment clinical trials based on cancer type.
  • To analyze sociodemographic characteristics of clinical trial participants in relation to cancer type.

Main Methods:

  • Utilized three data sources from 2010-2014, including institutional databases and the California Cancer Registry.
  • Analyzed 3,580 clinical trial participants and over 341,000 incident cancer cases.
  • Compared sociodemographic factors (age, sex, race/ethnicity, insurance) across different cancer types and populations.

Main Results:

  • Observed racial/ethnic disparities, with higher proportions of White individuals in cancer center and clinical trial populations compared to the catchment area.
  • Older adults were overrepresented in prostate cancer trials but underrepresented in breast and colorectal cancer trials.
  • Significant variations in insurance type were noted across cancer types between catchment area, cancer center, and clinical trial participants.

Conclusions:

  • Overall recruitment frequencies can obscure important differences in participant demographics across specific cancer types.
  • Findings underscore the need for cancer type-specific analyses to address recruitment disparities.
Keywords:
Cancer disparitiesPrecision medicineRecruitment scienceRepresentativeness in clinical trials

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