600P Ethnic and socio-economic status in ovarian cancer patients recruited to clinical trials

Abstract

Ethnicity and deprivation affect cancer outcomes. We sought to determine whether the ovarian cancer (OC) trial population was representative of the general OC population in terms of ethnicity and socio-economic status (SES), across two London tertiary cancer centres. All OC patients treated between 2017 and 2022 were included. Any patients participating in a clinical trial during this period were included in the trial population (TP) and the remainder classified as the non-trial population (NTP). Demographic and treatment data were collected from electronic patient records. Ethnicity was classified using NHS coding, based on the UK 2021 Census. The UK Indices of Multiple Deprivation (IMD) was calculated based upon postcode, grouped into quintiles. Pearson’s chi-square test was used to evaluate differences between TP and NTP. 215 TP and 680 NTP were included. In the TP; 88, 104 and 23 entered phase II, phase III or observational trials, respectively. 11 (5.1%) TP were non-English speaking. There was a statistically significant difference in SES (p=0.0260) and ethnicity (p<0.0001) between TP and NTP cohorts (Table).Table: 600PTP (n=215; %)NTP (n=680; %)P valueSocio-Economic Status: Indices of Multiple Deprivation (Quintiles)Q1 Most Deprived30 (13.9)107 (15.7)P = 0.0260Q250 (23.3)234 (34.4)Q351 (23.7)128 (18.8)Q435 (16.3)106 (15.6)Q5 Least Deprived43 (20.0)104 (15.3)Unclassified6 (2.8)1 (0.2)EthnicityAsian or Asian British14 (6.5)86 (12.6)P <0.0001Black (African, Black British, Black Caribbean, Black Other)11 (5.1)65 (9.6)Other ethnic group11 (5.1)53 (7.8)Mixed/Multiple Ethnic Groups8 (3.7)7 (1.0)White (British, Irish, Other)157 (73.0)381 (56.0)Unclassified14 (6.5)88 (12.9)The odds ratio for clinical trial enrolment was 0.69 (95% confidence interval (CI): 0.50 - 0.94; p=0.018) and 0.51 (95% CI: 0.35 - 0.74; p=0.003) for those more vs less deprived and in non-white vs white patients, respectively. Open table in a new tab The odds ratio for clinical trial enrolment was 0.69 (95% confidence interval (CI): 0.50 - 0.94; p=0.018) and 0.51 (95% CI: 0.35 - 0.74; p=0.003) for those more vs less deprived and in non-white vs white patients, respectively. Patients with higher levels of deprivation and non-white ethnicity were under-represented in clinical trials at our centres, which may worsen health disparities. Further research is required to understand the systematic, clinician-focused and patient-focused barriers to trial recruitment in such groups.