The impact of neighborhood socioeconomic deprivation on clinical trial enrollment at an NCI-designated cancer center.

person Amina Dhahri University of Kentucky, Markey Cancer Center, Department of Medical Oncology, Lexington, KY info_outline Amina Dhahri, Madison Ginn, Benjamin Daniel Powers, Aman Chauhan, John L. Villano, Lowell Brian Anthony, Ralph Zinner, Reema Anil Patel, Zhonglin Hao, Lovoria Williams, M. Cecilia Monge B., Susanne M. Arnold

Authors person Amina Dhahri University of Kentucky, Markey Cancer Center, Department of Medical Oncology, Lexington, KY info_outline Amina Dhahri, Madison Ginn, Benjamin Daniel Powers, Aman Chauhan, John L. Villano, Lowell Brian Anthony, Ralph Zinner, Reema Anil Patel, Zhonglin Hao, Lovoria Williams, M. Cecilia Monge B., Susanne M. Arnold Organizations University of Kentucky, Markey Cancer Center, Department of Medical Oncology, Lexington, KY, University of Kentucky, College of Medicine, Lexington, KY, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Department of Medical Oncology, University of Kentucky, Markey Cancer Center, Lexington, KY, University of Kentucky, Lexington, KY, University of Kentucky, College of Nursing, Lexington, KY, National Cancer Institute/National Institutes of Health, Bethesda, MD Abstract Disclosures Research Funding No funding received None. Background: Previous studies showed that SES is a barrier to cancer clinical trial enrollment. But, few studies have investigated the impact of socioeconomic deprivation (SED) on trial participation using a granular geocoded measure. To overcome this gap, we assessed trial enrollment at the only NCI-designated cancer center in Kentucky. Methods: We conducted a retrospective study of patients enrolled in GI and lung cancer trials from 2012 to 2021 using the Area Deprivation Index (ADI), a validated dataset that ranks census block groups based on SED and includes 17 variables. Patients with an identifiable state and national rank ADI were included and stratified in quintiles. Chi-square and Kruskal-Wallis tests were used for analysis. Results: We included 1130 patients who enrolled in a trial; 10 patient refused enrollment 0.9%. Trial participation by gender was similar: 50.5% female and 49.5% male. Race included White 93.5%, African American 5.7% and Asian 0.71% patients. Hispanics made 0.5% of the cohort. When assessed by national ADI, 45% of clinical trial participants were in the highest ADI quintile. When assessed by ADI state ranking, there was similar distribution in trial enrollment. Enrollment at the national and state levels were significant for age (p < 0.001, for both) and race (p = 0.003 and 0.023, respectively). Conclusions: Prior studies have shown that low SES is a barrier trial enrollment; however, this study demonstrates that using a granular measure of SED at the state level, GI and lung cancer clinical trial enrollment has similar distribution by ADI quintiles. But, when assessed at the national level, 45% of trial participants were in the highest SED quintile. This highlight the importance of state and national-level comparisons for SED and suggest that future research is needed to identify barriers and facilitators of cancer clinical trial enrollment. Lowest 0-19.9 Low 20-39.9 Moderate 40-59.9 High 60-79.9 Highest 80-100 p-value State ADI N 216 232 221 231 230 Age 64 56-73 63 54-70 61 54-67 61 54-67 60 53-68 < 0.001 Gender Female 96 44.4% 126 54.3% 109 49.3% 118 51.1% 121 52.6% 0.33 Male 120 55.6% 106 45.7% 112 50.7% 113 48.9% 108 47.4% Race African American 10 4.6% 6 2.6% 14 6.3% 21 9.1% 14 6.1% 0.023 Asian 5 2.3% 1 0.4% 0 0% 0 0% 2 0.9% White 201 93% 225 96.9% 207 93.7% 210 90.9% 214 93% Ethnicity Hispanic 0 0% 2 0.9% 2 0.9% 1 0.4% 1 0.4% 0.68 Non-Hispanic 208 96.3% 226 97.4% 210 95% 220 95.2% 220 95.7% Unknown 8 3.7% 3 1.3% 9 4.1% 10 4.3% 8 3.5% National ADI N 24 112 218 267 509 Age 64 53.5-71 68 58-74 61 53-69 62 54-68 61 54-67 < 0.001 Gender Female 8 33.3% 48 42.9% 114 52.3% 143 53.6% 257 50.5% 0.44 Male 16 66.7% 64 57.1% 104 47.7% 124 46.4% 251 49.5% Race African American 0 0% 3 2.7% 11 5% 14 5.3% 36 7.1% 0.003 Asian 2 8.3% 3 2.7% 1 0.5% 0 0% 2 0.4% White 22 91.7% 106 94.6% 206 94.5% 253 94.7% 471 92.5% Ethnicity Hispanic 0 0% 0 0% 1 0.5% 1 0.4% 4 0.8% 0.97 Non-Hispanic 24 100% 108 96.4% 209 95.9% 258 96.6% 485 95.3% Unknown 0 0% 4 3.6% 8 3.7% 8 3% 20 3.9%