Overcoming barriers to accrual: An assessment of 1,187 cancer patients’ (Pts) and caregivers’ awareness of and willingness to participate in cancer clinical trials (CCTs)

Abstract

6016 Background: Only 3% of pts participate annualy in CCTs. Barriers to accrual include lack of CCT awareness and uncertain third party payer coverage. In January 2002, a new California law (Senate Bill 37 [SB37]) required all third party payers to reimburse pt care costs related to CCTs. We evaluated the level of awareness of pts and/or their caregivers regarding CCTs and SB37. Methods: We employed both a written survey for pts and/or caregivers seen for the first time in an oncology clinic within the UCDCC catchment area, and a verbal telephone version for callers to the CIS. We used Spearman’s correlation and Pearson’s Chi-Square to test for correlations between CCT “awareness” (subjects had heard of CCT and agreed that it tests the safety and usefulness of a new drug)/SB37 knowledge, and willingness to participate in CCTs. Logistic regression was performed to assess predictive variables for awareness and willingness to participate. Results: Of the 1,187 respondents, 59% were aware of CCTs, 19% knew of SB37, and 33% were very likely to consider a CCT. There were significant positive correlations between CCT awareness and willingness to participate (p<0.0001, Spearman), and between SB37 knowledge and willingness to participate (p=0.0012, Pearson Chi-square). Reduced awareness of CCTs was seen in respondents who were either Black (odds ratio [OR] 0.44, p=0.0036), Hispanic (OR 0.56, p=0.03), had an annual income <$25,000 (OR 0.38, p<0.0001), or had less than a college degree (OR 0.12 to 0.53, p<0.0001 to 0.013). Reduced willingness to participate in CCTs was seen in respondents who were either Black (OR 0.38, p<0.0001), or Asian (OR 0.44, p<0.0057). Conclusions: Improving clinical trial awareness and SB37 knowledge, especially among lower income, less educated, and minority pts, may potentially overcome barriers to CCT participation and subsequently increase accrual in California. (R21 CA10172; VANCHCS; ACS CRTG 00197101CCE to PNL) No significant financial relationships to disclose.