Structural, Clinical Barriers Prevent Cancer Trial Participation

Trial unavailable at patients' institution 55.6 percent of the time; 21.5 percent of patients ineligible
doctor and patient
doctor and patient

WEDNESDAY, Feb. 20, 2019 (HealthDay News) -- Structural and clinical barriers prevent most cancer patients from participating in clinical trials, according to a review published online Feb. 19 in the Journal of the National Cancer Institute.

Joseph M. Unger, Ph.D., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues conducted a systematic review and meta-analysis to examine the magnitude of different trial barrier domains. Structural (trial availability), clinical (eligibility), and patient/physician barrier domains were characterized and quantified using a uniform framework. Thirteen studies with 8,883 patients were identified.

The researchers found that 55.6 percent of the time, a trial was unavailable for patients at their institution. In addition, 21.5 and 14.8 percent of patients were ineligible for an available trial or did not enroll, respectively; 8.1 percent enrolled. The rates of trial enrollment differed in academic and community settings (15.9 versus 7 percent); the rates of trial unavailability, ineligibility, or nonenrollment did not differ.

"These findings illustrate the need to re-examine the way we think about patient participation in clinical trials," Unger said in a statement. "Most of the time it's not up to the patient. Instead, structural and clinical barriers are the reasons more than three out of four patients do not participate in trials."

Abstract/Full Text

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