Accrual of under-represented minority women to breast cancer clinical trials in Inland Empire, California.

Abstract

64 Background: Ethnic minority women are currently underrepresented in breast cancer clinical trials. The age-adjusted incidence and mortality rates for breast cancer are higher in Riverside and San Bernardino Counties (Inland Empire), California, than the statewide average. During the 10 years of enrollment at Loma Linda University Cancer Center (LLUCC) between 1999 and 2009, a total of 151 patients were enrolled to breast cancer clinical trials. Among the enrolled patients, only 26.7% were ethnic minority women in contrast with the 59% of ethnic minority women living in Inland Empire. Methods: A countywide breast cancer awareness campaign using billboard, print ads, and newsletters, combined with direct mailing sent to regional physician offices and breast imaging centers was launched. We specifically addressed previously identified barriers to participation in clinical trials, such as lack of medical insurance, time, invitation, awareness of available studies, access to the institution or doctors conducting the trial, and coordination among clinics. In addition, we utilized a culturally sensitive multidisciplinary team to address the breast cancer care for minority women. Results: During the two year period since implementation of the regional culturally sensitive breast cancer awareness campaign, we successfully enrolled 32 patients into breast cancer clinical trials. Minority breast cancer patient accrual increased from a 10-year average of 26.7% to 46.9% in comparison with non-Hispanic white patients (p=0.02). The accrual rate of Hispanic population increased from 10% to 21.9%. The accrual rate of black patients increased from 5.3% to 12.5%. Conclusions: The use of materials specifically targeting known barriers to participation in clinical trials successfully improved accrual of minority women, and has the potential to improve the cure rate, decrease disparities in breast cancer care, and eventually decrease the breast cancer burden particularly in underserved minority groups in Inland Empire, California.