Cancer Clinical Trial Participation Amongst Culturally and Linguistically Diverse Patients in Australia

Clinical trials play a large role in oncological. Many barriers to participation in cancer clinical trials exist, including a patient's status as "culturally and linguistically diverse (CALD)". Globally, it is thought that CALD patients experience lower rates of trial participation, although very few studies quantify rates of cancer clinical trial participation in this group. Our study therefore aims to characterize CALD participation in cancer clinical trials in an Australian setting.

We conducted a retrospective analysis of data from the Cancer Clinical Trials Centre at Austin Health, a large tertiary metropolitan cancer center in Melbourne, Australia. Participation in cancer clinical trials between groups was compared using simple descriptive analysis, Chi-squared analysis, and logistic regression.

Of 2568 patients (mean age 57.9 years, 37% female) offered entry into a cancer clinical trial between 2018 and 2023, 26% were from a CALD background (n = 678), and 9% had a preferred language other than English (n = 219). A greater proportion of non-CALD patients participated in a cancer clinical trial compared with CALD patients (37% versus 33% respectively, p = 0.04). In logistic regression models, Arabic (OR, 0.46; 95% CI, 0.21-0.93 [univariate]) and Greek (OR, 0.54; 95% CI, 0.31-0.91 [multivariate]) language groups, along with overall CALD status (OR, 0.81; 95% CI, 0.67-0.99 [univariate]) were associated with lower cancer clinical trial participation.

We found that CALD patients, those born in non-English speaking countries, and specific language groups, were associated with lower cancer clinical trial participation.