Overview
It is well-recognized that access to clinical trials is a critical component of high-quality cancer care; however, equitable access to and participation in oncology clinical trials remains suboptimal. This study aimed to inform which patient groups are more likely to have inequitable access to oncology research studies, and whether representativeness may be improved by expanding research capabilities in practices that do not currently participate.
The research found, based on an analysis of over 550,000 patients across 178 community practices, that practices with low research engagement served higher proportions of patients who are Black, Latinx, without known insurance, and at the lowest socioeconomic status, while practices with high research engagement served higher proportions of patients who are White, insured, and at higher socioeconomic status.
These findings suggest that investments to expand the clinical research footprint among practices with low research engagement could help address persistent inequities in cancer clinical trial representation.
Why this matters
This is the first national study to report that patient groups historically underrepresented in oncology clinical trials are the very same patient groups more likely to be treated at community practices with limited or no access to trials. There is an emerging role technology can play to address this issue and assist the viability and sustainability of new and established community research programs. Software such as patient screening tools and EHR-to-EDC connectors that facilitate automated study data entry significantly reduce the burden of research operations and can help enhance infrastructure at sites with low research engagement. This work demonstrates that expanding clinical trial availability to patients wherever they receive their care will help move the needle on equitable access, trial representativeness and generalizability of oncology study results.