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Geographic Disparities in Access to Cancer Clinical Trials in Canada

Omar Abdel-Rahman1

  • 1Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada.

American Journal of Clinical Oncology
|August 29, 2023
PubMed
Abstract

Insights

Geographic and cancer type disparities exist in Canadian cancer clinical trials access. The COVID-19 pandemic also negatively impacted trial accessibility, highlighting inequities in clinical trial participation.

Area of Science:

  • Oncology
  • Clinical Trials Research
  • Health Services Research

Background:

  • Equitable access to cancer clinical trials is crucial for advancing cancer care and ensuring all patients can benefit from novel treatments.
  • Geographic and demographic factors can influence patient participation in clinical trials, potentially leading to disparities in access.

Purpose of the Study:

  • To evaluate geographic disparities in access to cancer clinical trials across Canada.
  • To analyze trends in cancer clinical trial registration and funding sources.
  • To compare cancer clinical trial availability between Canada and the United States.

Main Methods:

  • Reviewed cancer clinical trial data from clinicaltrials.gov for trials conducted in Canada between 2005 and 2023.
  • Conducted frequency analyses based on location (national, provincial, urban centers), cancer type, funding source, and time period.
  • Calculated cancer clinical trials per 10,000 persons for Canada and the US.

Main Results:

  • Significant geographic disparities were observed, with cancer clinical trials per 10,000 individuals ranging from 6.79 in New Brunswick to 0 in the territories.
  • Lymphoma trials (32.85 per 1000 cases) were most numerous relative to projected cases, while bladder cancer trials (7.06 per 1000 cases) were least numerous.
  • Industry funding comprised 69% of trials, and the highest trial activity occurred between 2014-2016, with a notable decrease from 2020-2022.

Conclusions:

  • Access to cancer clinical trials in Canada is inequitably distributed, influenced by geographic location and primary tumor site.
  • The COVID-19 pandemic has further exacerbated existing disparities in access to cancer clinical trials.
  • Addressing these disparities is essential for improving cancer care outcomes nationwide.

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