Abstract
Purpose: To increase access of underserved/health disparities communities to National Cancer Institute (NCI) clinical trials, the Radiation Research Program piloted a unique model – the Cancer Disparities Research Partnership (CDRP) program. CDRP targeted community hospitals with a limited past NCI funding history and provided funding to establish the infrastructure for their clinical research program.Methods: Initially, 5-year planning phase funding was awarded to six CDRP institutions through a cooperative agreement (U56). Five were subsequently eligible to compete for 5-year implementation phase (U54) funding and three received a second award. Additionally, the NCI Center to Reduce Cancer Health Disparities supported their U56 patient navigation programs.Results: Community-based hospitals with little or no clinical trials experience required at least a year to develop the infrastructure and establish community outreach/education and patient navigation programs before accrual to clinical trials could begin. Once established, CDRP sites increased their yearly patient accrual mainly to NCI-sponsored cooperative group trials (~60%) and Principal Investigator/mentor-initiated trials (~30%). The total number of patients accrued on all types of trials was 2,371, while 5,147 patients received navigation services.Conclusion: Despite a historical gap in participation in clinical cancer research, underserved communities are willing/eager to participate. Since a limited number of cooperative group trials address locally advanced diseases seen in health disparities populations; this shortcoming needs to be rectified. Sustainability for these programs remains a challenge. Addressing these gaps through research and public health mechanisms may have an important impact on their health, scientific progress, and efforts to increase diversity in NCI clinical trials.
Highlights
IntroductionOver half of all cancer patients are treated with radiation alone or in combination with surgery or chemotherapy
The Cancer Disparities Research Partnership (CDRP) pilot program was initiated by the radiation research program (RRP) within the National Cancer Institute (NCI)’s Division of Cancer Treatment and Diagnosis (DCTD) in 2002 as a novel strategy to address the cancer health disparities that exist in racial, ethnic, minority, and underserved populations within the United States (1)
All CDRP sites were active to various degrees in publishing results of their cancer disparities program with Rapid City Regional Hospital (RCRH) being the most productive with publications (Table 6)
Summary
Over half of all cancer patients are treated with radiation alone or in combination with surgery or chemotherapy. This program was focused at radiation oncologists in communitybased hospitals and cancer centers that predominantly serve minority/underserved populations. Utilizing a U56 planning cooperative agreement, funding went directly to community-based institutions to establish the clinical research infrastructure required for their populations to access NCI-sponsored radiation oncologybased clinical trials. NCI’s Center to Reduce Cancer Health Disparities (CRCHD) provided supplemental funding to establish a patient navigation program addressing the specific needs of grantee’s targeted populations
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