Evaluation of adolescents and young adults (AYA) attitudes towards participation in cancer clinical trials.

Abstract

10047 Background: Participation in clinical trials (CT) for AYA ( < 39 years) remain the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CT participation. Methods: A mixed methods approach included 1) qualitative: interpretive descriptive methodology guided individual semi-structured interviews with 21 AYA for factors influencing CT enrollment and 2) quantitative: AYA and non-AYA (≥40) matched for histology completed Cancer Treatment subscale of Attitudes toward Cancer Trials Scales (ACTS-CT) (Schuber, 2008) and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test and ordered logistic regression models were constructed for prediction of the effect of baseline demographics. Results: The major themes influencing CT participation were: (1) family/peer group opinion (2) CT impact on daily/future life (e.g. school; starting a family) and (3) illness severity/psychological readiness for CT information. Surveys were distributed to 61 AYA (median age: 29 years (17-39)); 74 non-AYA (55 (40-88)). Compared with non-AYA, AYA perceived CT to be unsafe/more difficult (Personal Barrier/Safety domain; p = 0.01). AYA were also more concerned with CT interference in their long term goals (p = 0.04). Logistic regression identified participants who had previously been offered a CT (p = 0.01) or who spoke English as their first language (80% of cohort)(p = 0.01) reported less barriers to CT. There were no differences based on age in other domains (Personal Benefits; Personal/Social Value; Trust in CT). In all participants, differences were seen in the Personal Benefits domain if respondents had children (p = 0.05) or were currently working (p = 0.04). Conclusions: Age-related differences in attitudes towards CT suggest that tailored approaches to CT accrual of different patient groups may be warranted. Patient-centered delivery of information regarding CT, particularly for those in whom English is a second language and who are trial-naïve, may improve accrual and warrants further prospective, randomized study.