Disparities in clinical trial participation: Survey of patients with cancer at an academic medical center.

person Katie Moreland University of Cincinnati College of Medicine, Cincinnati, OH info_outline Katie Moreland, Melinda Butsch Kovacic, Shesh Rai, Davendra Sohal

Authors person Katie Moreland University of Cincinnati College of Medicine, Cincinnati, OH info_outline Katie Moreland, Melinda Butsch Kovacic, Shesh Rai, Davendra Sohal Organizations University of Cincinnati College of Medicine, Cincinnati, OH, Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, OH Abstract Disclosures Research Funding No funding sources reported Background: This study aims to understand cancer patients' attitudes toward clinical trials and identify barriers to participation, because low participation, especially among minorities, perpetuates poor outcomes and disparities. Methods: A survey was conducted at the University of Cincinnati Cancer Center (UCCC) to assess patients' experiences and attitudes toward clinical trials, previous trial participation, and future trial interest. The pen-and-paper survey, administered by a coordinator (KM), took 5-10 minutes. Frequency tables and Chi-square tests in SAS summarized the findings. Results: From April to August 2023, a survey was offered to solid tumor patients at UCCC during their clinic visits. Participation was voluntary; 300 patients completed the survey. The cohort had 56% females and 77% Whites, with equal educational levels up to (51%) and beyond high school (49%), but with notable racial differences (Table). Index cancer diagnoses were lung (15%), head/neck (11%), breast (10%), colorectal (8%), pancreatic (8%), ovarian (6%), prostate (6%), gastroesophageal (6%), endometrial (5%), and various others (25%). Of 300 participants, only 32% had ever been asked to participate in a clinical trial; more Whites vs non-Whites; 84% chose to participate, with notable differences by race (Table). These differences were not attributable to education or sex. Of the 81 patients who chose to participate, 96% participated to gain access to new treatments, and 75% participated to contribute to research; only 11% did it for financial incentives. There were also differences by race among the 15 who declined participation (Table). Of the 203 who had never been asked to participate in a trial, 71% indicated that they would be willing to participate in the future, but with a strong sex:race interaction (Table). Nearly all (99%) indicated that they would participate to have access to new treatments; many (57%) wanted to contribute to research. Conclusions: This survey shows that many solid tumor patients are not offered clinical trials, and reveals racial disparities in patient willingness, especially among non-White men. Promisingly, there's a notable readiness among patients to join trials for treatment access and research. Efforts should focus on improving clinical trial portfolios, enhanced outreach, and target population education and trust-building. White (n=232) Non-White (n=68) p-value, if <0.05 > High school education 127 (55%) 20 (29%) 0.0002 Invited to participate in a clinical trial 82 (35%) 14 (21%) 0.021 Chose to participate in a clinical trial 72/82 (88%) 9/14 (64%) 0.023 If asked in the future, willing to participate 112/149 (75%) 32/54 (59%) 0.024 Women 65/82 (79%) 23/31 (74%) Men 47/67 (70%) 9/23 (39%) 0.008 Of those declining, reason: Don’t trust 0/10 (0%) 1/5 (20%) Safety concern 3/10 (30%) 3/5 (60%) Don’t want experimental treatments 5/10 (50%) 5/5 (100%)