Geographic and socioeconomic determinants of participation by elderly patients in surgical oncology trials.

Abstract

6127 Background: A recent report by our group demonstrated that <0.5% of elderly patients with breast, prostate and lung cancer participate in surgical oncology trials. However, little work to date has evaluated the roles of regional healthcare infrastructure and socioeconomic factors on clinical trial participation in this cohort. Methods: The NCI Cooperative Group Surgical Oncology Trial (CGSOT) database was queried for patients treated for breast, prostate and lung cancer cancer between 2000 and 2008 (n=13,541). Geographical Information Systems data were used to evaluate proximity to healthcare facilities while regional socioeconomic characteristics were obtained from the 2000 US Census and Area Resource file. Counts were used to create a proportion of respondents with the corresponding 95% confidence interval calculated using the central limit theorem. Independent t-tests were used to assess differences in outcome measures between the two age groups. Results: We found that 4136 participants in the NCI CGSOT database were 65 years of age or older. Interestingly, 92.7% of this cohort was white and 85.7% was female. Socioeconomic determinants of participation are shown in the table. Conclusions: The work presented herein suggests that elderly minority patients are less likely to participate in surgical oncology trials than their white counterparts. Furthermore, elderly participants tend to reside in less affluent areas. Future work will utilize interventions that improve the recruitment of elderly patients to these trials. [Table: see text]