A Retrospective Study of Social Determinants of Health Effects on Clinical Trial Consideration

Clinical trials offer access to advanced treatments, yet only 2-10% of cancer patients participate. Many factors contribute to patient participation, including patient social determinants of health (SDOH) such as age, rurality, race, education, and socioeconomic status. The purpose of this study is to determine if SDOH measures are related to clinical trial participation in a community cancer center in the great plains.

A retrospective study was conducted by evaluating all patients treated for malignancy in the oncology electronic health record (EHR) between 2018 and 2022. Demographic information was also obtained from the EHR. U.S. Census Bureau data was used to define location as urban or rural. Documentation available of formal consideration for clinical treatment trial screening came from cancer research departmental data.

During the study period, 15,514 patients were treated for malignancy (WCP). Of those, 1,311 had documentation available showing formal consideration for clinical treatment trial screening (SCT group). Urban patients made up 22.5% of the WCP and 32.0% of SCT group. SCT population lived a median distance of 69.9 miles from the study site whereas the median distance from study site for WCP was 89.8 miles. Screened patients had an average age of 67.2 while the average age for all patients was 72.3. SCT group was 94.7% Caucasian and WCP was 93.1% (p = 0.033). 78.1% of WCP spoke English while 79.9% screened did (p = 0.14).

The available data from the EHR and ancillary data sources had significant limitations with potential for impacting validity of endpoints. While this data provides areas that are opportunities of focus for potential improvement, additional studies will be needed to further assess the true impact of SDOH in consideration for clinical trial involvement.