Crozer Chester Medical Center, Upland, PA
Devashish Desai, Swe Swe Hlaing, Aakash Goyal, Alan Keogh
Background: Healthcare disparities exist in patients living with cancer which could be due to age, sex, race or sociodemographic variables. This study was undertaken to analyze the racial representation in oncology clinical trial study population of selected cancers over a period of 13 years. Methods: ClinicalTrials.gov was utilized for data collection. Clinical trials in 4 major cancers were filtered using the following criteria in advanced search: Disease, Study type: Interventional (Clinical trial), Study results: Studies with results, Status: Completed, Location: United States, Phase: 3 or 4, Last updated: 01/01/2009 to 01/01/2022. Prostate Cancer (PC), Colorectal Cancer (CRC), Breast Cancer (BC), and Lung Cancer (LC) were included in the study. Data were collected in an Excel spreadsheet and descriptive statistics were used for analysis. Comparison of racial representation was made with the National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER) 2019 data for respective cancers. Results: 165 (52.21%) studies out of 316 studies, which met inclusion criteria, were disclosing racial demographic data. Breaking down into respective cancers, PC had 57.69%, LC had 59.04%, CRC had 44.12%, and BC had 46.28% clinical trials with racial demographic data. Table shows detailed racial demographic data of cancers included with comparison to SEER’s incidence data. Whites/Caucasians (Whites) were the most common race in all the cancer trials, followed by Asian/Pacific Islanders (API) in LC, CRC and BC while Blacks/African Americans (AA) being second common in PC. American Indians/Alaskan Natives (AI/AN) were least represented in all the cancer trials. In comparison to SEER’s 2019 incidence data AA and AI/AN were under-represented in all the included cancer trials, while Whites were over-represented. Conclusions: It is prudent to address the issue of racial disparities in clinical trials. To begin with, it is imperative to include racial demographics in the results, as only 52.21% trials had racial demographic data. AA and AI/AN are under-represented in all the included cancer trials while Whites were over-represented, hindering the generalization of the trial results. It is important to make changes at the grass root level, meaning at the conception of the trial and at the research regulatory level.
PC | LC | CRC | BC | |||||
---|---|---|---|---|---|---|---|---|
Study data | Seers data | Study data | Seers data | Study data | Seers data | Study data | Seers data | |
Total study pop. | 67,497 | 27,675 | 18,830 | 43,452 | ||||
White | 55,503 (82.23%) | 123.0 | 21,630 (78.16%) | 56.7 | 15,254 (81.01%) | 38.0 | 33,791 (77.77%) | 143.3 |
AA | 5931 (8.79%) | 203.2 | 1339 (4.84%) | 54.4 | 1367 (7.26%) | 44.3 | 1559 (3.59%) | 137.1 |
API | 1054 (1.56%) | 67.3 | 3871 (13.99%) | 35.6 | 1608 (8.54%) | 30.8 | 6466 (14.88%) | 115.2 |
AI/AN | 193 (0.28%) | 88.3 | 67 (0.24%) | 49.7 | 39 (0.21%) | 49.3 | 412 (0.95%) | 138.5 |
Others | 4639 (6.87%) | 761 (2.75%) | 562 (2.98%) | 1252 (2.88%) |
SEERS data in “per 100,000 person"
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