Behind the Numbers: Cancer Survivor Recruitment by Demographics and Clinical Status

Recruiting cancer survivors to research studies requires multiple steps that may be differentially challenging across groups of survivors.

We examined associations between progression through recruitment steps and sociodemographic and clinical characteristics of survivors invited to participate in the Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health randomized control trial of web-based healthy lifestyle interventions.

Survivors from two population-based cancer registries and a hospital registry (n = 23,270) were mailed an AMPLIFI invitation letter then called by recruiters. Outcomes included being (1) reached by recruiters, (2) screened for eligibility, (3) deemed eligible, and (4) consented. Bivariate and logistic regression analyses examined associations with sociodemographic and clinical factors.

7742 (33.3%) survivors were reached. Being reached was positively associated with being female, age 65+, African American, urban resident, and < 2 years from cancer diagnosis; negatively associated with colorectal cancer. Among those reached, 7438 were offered screening and 2278 (30.6%) were screened. Being screened was positively associated with being female, African American, and < 2 years from diagnosis; negatively associated with age 65+, resident in high disadvantage areas, survivor of colorectal cancer. Of survivors screened, 716 (32%) were eligible. Being eligible was positively associated with < 2 years from diagnosis; negatively associated with colorectal and kidney cancer. Of those eligible, 438(61.2%) consented to participate. Being consented was negatively associated with being African American and from high disadvantage areas.

Outcomes across recruitment steps vary by survivors' characteristics indicating that opportunities exist for tailored approaches to promote greater overall diversity in clinical trials.