Barriers to recruitment of rural patients in cancer clinical trials

Abstract

17502 Background: With advancement in research, it is imperative for clinical trials to be accurate and generalizable. This is best achieved through improving patient participation in clinical trials. However, according to the National Cancer Institute, only 3% of adult cancer patients participate in clinical trials. Although, several studies have looked into the barriers to accrual in clinical trials amongst various patient subgroups, there is lack of data regarding factors that influence enrollment of rural patient population. Our study aims to identify these barriers in an attempt to improve future participation. Methods: Amongst patients with a known cancer diagnosis who followed with the Mary Babb Randolph Cancer Center at West Virginia University, we randomly selected 1000 patients. Questionnaires were mailed to the patients. Data obtained in the questionnaire consisted of demographics, clinical information, awareness about clinical trials, willingness to participate in and factors influencing participation in clinical trials. Patients had six weeks to respond. The data was tabulated and analyzed using SPSS. Results: 241 patients responded to the survey. Most respondents (68.4%) had heard about clinical trials prior to the survey. 20.3% reported of their healthcare team discussing about clinical trials. 9.2% reported having participated in clinical trials. Most respondents reported that they (87.3%) and their families (70.9%) participated in healthcare decisions. Respondents were more likely to be at least somewhat willing to participate in a cancer screening trial compared to a new cancer drug trial. With regards to their decision to participate in cancer clinical trials, patients cited discouragement from oncologist (62.5%), monetary burden (53.4%), discouragement from family physician (49.5%) and lack of information (35%) as strongly/extremely influential factors. Conclusions: Our findings specify the need for patient education through community outreach programs and through educating physicians about cancer clinical trials. Physicians should be trained to discuss clinical trial protocols and to address patient concerns regarding availability, utility and accessibility of clinical trials. Financial counseling can play an important role in improving accrual rates. No significant financial relationships to disclose.