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Disparities in Surgical Oncologic Care

Disparities Poster Presentations

P20: Minority Reporting and Representation in Cancer Clinical Trials: A Study of over 12,000 Clinical Trials

Friday, March 22, 2024
3:33pm – 3:39pm ET
Location: SSO HUB Theater
Disclosure(s):
E. Shelley Hwang, MD, MPH: Exai Bio: Advisor (Ongoing)
Introduction: Although racism is increasingly recognized as a public health crisis, minority racial groups continue to be underrepresented in clinical trials. The impact of recent efforts toward improving minority representation in cancer clinical trials is unknown. 


Methods: Using the ClinicalTrials.gov database from March 2000 to July 2023, we analyzed all interventional cancer clinical trials in the US of the top ten leading causes of solid-tumor cancer deaths. We compared race reporting data pre-2020 (before 1/1/20) vs. post-2020 (after 1/1/20). Differences across groups were tested using the chi-square test for categorical variables and Mann Whitney tests for continuous variables 


Results: Of 12,864 cancer clinical trials with reported results, the majority of trials were academically funded (62%), treatment-based (78%), multi-center trials (52%). The most common tumor sites studied were breast (27%), lung (21%), prostate (16%) and colorectal (11%).  Of all clinical trials reporting results during the study period, only 47% of clinical trials reported race/ethnicity enrollment data. The rate of race/ethnicity reporting was highest in industry sponsored trials (industry 49%, academic 47% government 41%, p< 0.001), though all three trials sponsors had increasing rates of race/ethnicity reporting over time (Figure 1). Compared to clinical trials conducted before 2020 (n=10,611), clinical trials conducted in or after 2020 (n=2253) were significantly more likely to report race/ethnicity data (47% vs 88%, p< 0.001).  Among trials with race reporting data (n=5725), trials reported consistent representation by White participants (92%). Compared to pre-2020, however, there was an increase in non-White race reporting across all minority groups post-2020 (Black 62% vs. 76%, Hispanic/Latino 58% vs 61%, Asian 83% vs. 86%, American Indian/Alaska Native 60% vs. 72%; all p< 0.001). 


Conclusions:

The majority of US cancer clinical trials conducted over the last two decades did not report race/ethnicity data.  However, reporting of non-White race participation in cancer clinical trials has increased markedly since 2020. Future studies will assess whether increased minority representation in cancer clinical trials will help bridge existing profound health disparities.

Learning Objectives:

  • Describe the rate of race/ethnicity data reporting by cancer clinical trials over the last twenty years with an understanding of recent trends.
  • Demonstrate difference in race/ethnicity data reporting as well as patient enrollment demographics by clinical trial sponsor and disease site.
  • List historic and current patterns of patient enrollment in cancer clinical trials by race/ethnicity.