Abstract B118: Racial and ethnic minorities remain underrepresented in cancer clinical trials despite local cancer incidence

Abstract

Abstract Introduction: Over the last two decades, racial and ethnic minorities have been underrepresented in cancer clinical trials. Some have suggested that location is a barrier to inclusion in cancer clinical trials. The aim of this project is to assess how diversity of cancer clinical trials reflect their surrounding communities. Methods: Cancer clinical trials for the top five most deadly cancers including lung, breast, prostate, colon and pancreatic were selected from ClinicalTrials.gov. Trials were excluded if they were conducted outside the US or in multiple NIH-designated health service areas (HSA). Location-specific enrollment fractions were determined by comparing the proportion of trial participants to the local cancer incidence. National Cancer Institute (NCI) and Centers for Disease Control and Prevention (CDC) state cancer profiles (statecancerprofiles.cancer.gov) were used to determine HSA-specific data of cancer incidence by race and ethnicity. Results: 904 cancer clinical trials were identified from 2008-2022, including lung (n=157), breast (n= 330), prostate (n=219), colon (n=111) and pancreas (n=87). Overall, reporting of race and ethnicity was poor with only 53.6% of total trials reporting race and 35.9% reporting ethnicity. Compared to the local cancer incidence surrounding trial centers, White patients were overrepresented (p<0.0001), whereas Black (p<0.0001), Asian/Pacific Islander (p<0.0001), American Indian/Alaskan (p<0.0001) and Hispanic (p=0.004) were underrepresented. Furthermore, Black patients were underrepresented across breast (p=0.009), prostate (p<0.0001), lung (p<0.0001), colon (p=0.027) and pancreas (p<0.0001) cancer clinical trials when compared to the local cancer incidence. Conclusion: Racial and ethnic minority patients remain underrepresented in cancer clinical trials when compared to local cancer incidence. These findings reaffirm that location is not the only barrier to cancer clinical trial participation. Further efforts are needed to reduce healthcare disparities and improve patient care. Citation Format: Kelly M. Herremans, Andrea N. Riner, Vignesh Vudatha, Devon C. Freudenberger, Jose G. Trevino. Racial and ethnic minorities remain underrepresented in cancer clinical trials despite local cancer incidence [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B118.