Racial and ethnic minorities, women, and the elderly were less likely to enroll in
cancer clinical trials than whites, men, and younger patients, according to a study in the June 9 issue of the
Journal of the American Medical Association (
JAMA).
According to background information provided by the authors, "Ten years have passed since Congress responded to concerns about unequal access to clinical trials and enacted the National Institutes of Health (NIH) Revitalization Act, which encouraged representation of women and minority patients in NIH-sponsored research. Ensuring broad access to research studies has subsequently been an important aim of national research policy."
Vivek H. Murthy, M.D., M.B.A., and colleagues from the Yale University School of Medicine, New Haven, Conn., analyzed data from participants in therapeutic nonsurgical National Cancer Institute (NCI) Clinical Trial Cooperative Group breast, colorectal, lung, and prostate cancer clinical trials in 2000 through 2002. In a separate analysis, the ethnic distribution of patients enrolled in 2000 through 2002 was compared with those enrolled in 1996 through 1998. The study focused on those four types of cancer trials because they were the four most common causes of cancer-related deaths during the study period.
"From 1996 through 2002, 75,215 patients were enrolled in NCI-sponsored cooperative group nonsurgical treatment trials for breast, lung, colorectal, or prostate cancers. Approximately 3.1 percent of trial participants were Hispanic, 85.6 percent were white, 9.2 percent were black, 1.9 percent were Asian/Pacific Islanders, and 0.3 percent were American Indians/Alaskan Natives," the researchers report. "Trial participants represented approximately 1.7 percent of the total number of incident [new] cancer cases diagnosed during the 2000 through 2002 study period. When all four cancer types were considered in aggregate, Hispanics and blacks were underrepresented," the authors write.
"There was a strong relationship between age and enrollment fraction [number of trial enrollees divided by the estimated U.S. cancer cases in each subgroup], with trial participants 30 to 64 years of age representing 3.0 percent of incident cancer patients in that age group, in comparison to 1.3 percent of 65 - to 74-year-old patients and 0.5 percent of patients 75 years of age and older. … Although the total number of trial participants increased during our study period, the representation of racial and ethnic minorities decreased. In comparison to whites, after adjusting for age, cancer type, and sex, patients enrolled in 2000 through 2002 were 24 percent less likely to be black." The researchers also found that men were more likely than women to enroll in colorectal and lung cancer trials.