Barriers to Participation in Cancer Clinical Trials: Improvements Recommendations for Missed Opportunities to Address Disparities

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Advisor: B Smith, Thomas Jefferson University, Philadelphia, PA


The purpose of this study is to investigate the relationship between declining participation in a cancer clinical trial and demographic variables associated with those participants. Data from the 2008-2009 Jefferson Department of Radiation Oncology Screening Logs and the Jefferson University Hospital Medical Records Systems were used for the analysis. Individuals who were asked to participate in a consent interview conducted by a member of the research staff between November 2008 and May of 2009 were included in the analysis. There were a total of 104 observations, 38 of which met the criteria for declining participation. A total of 32 females and 72 males were asked to participate. Forty-seven percent of women declined participation in comparison with 32% of males. The percentage of adults most frequently consented were between the ages of 45-65 however, all age groups declined participation at similar rates. The average driving distance for those who declined was 22.6 miles in comparison to 25.8 miles for those who chose to participate. From the group of patients who declined, the maximum driving distance was 88.9 miles as compared with a maximum of 132 miles from those who participated. A total of 13% of African American patients were asked to participate. Of all minority groups, African Americans were most likely to decline participation. We then investigated if health insurance type influenced an African American patient’s decision to participate. We found that African American patients with public insurance declined participation 83% of the time compared with 37.5% of privately insured.