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Why Don’t More Minority Cancer Patients Participate in Clinical Trials?

That’s the big question a team of radiation oncology researchers in Philadelphia has been trying to answer. Making sure people of color are represented in clinical trials for new treatments can play an important part in helping to close the gap of racial and ethnic disparities in cancer outcomes. Yet historically, minority cancer patients have enrolled in clinical trials at a significantly lower rate then their Caucasian counterparts, says the research study’s lead author, Charles Wood, MD, a radiation oncologist at the Hospital of the University of Pennsylvania.

To identify and gain an understanding of the factors that influence a cancer patient’s decision to enroll in a clinical trial, the researchers surveyed a group of 166 patients at two radiation oncology clinics over a period of eight months. The patients ranged in age from 15 to 84, with a median age of 56. Their most common cancer diagnoses were prostate, head and neck, and breast cancer. Sixty-five percent of the participants were Caucasian and 35% were people of color.

The study’s results, presented last fall at the 2004 annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), reveal some striking differences between Caucasian patients’ and minority patients’ attitudes about clinical trials. The most significant finding was that minority patients are less likely to enroll in a trial unless the chances are high that it would benefit them. Sixty-four percent of the minority patients indicated that they would need a greater than 50-50 chance of benefiting from the trial, compared to only 45% of Caucasian patients.

The research also found that while minority and Caucasian patients were equally interested in learning about clinical trials, there were important differences in how and where they obtained this knowledge. Caucasian patients were more likely to gather information about trials from the Internet (31% vs. 11%) and by talking with their doctors (50% vs. 34%). In contrast, minority patients were more apt to obtain information about clinical trials by talking with other patients (25% vs. 12%). Furthermore, minority patients were more likely to believe they had been treated in the past on a clinical trial without their knowledge (22% vs. 9%).