The impact of neighborhood socioeconomic deprivation on clinical trial enrollment at an NCI-designated cancer center.

Abstract

e18614 Background: Previous studies showed that SES is a barrier to cancer clinical trial enrollment. But, few studies have investigated the impact of socioeconomic deprivation (SED) on trial participation using a granular geocoded measure. To overcome this gap, we assessed trial enrollment at the only NCI-designated cancer center in Kentucky. Methods: We conducted a retrospective study of patients enrolled in GI and lung cancer trials from 2012 to 2021 using the Area Deprivation Index (ADI), a validated dataset that ranks census block groups based on SED and includes 17 variables. Patients with an identifiable state and national rank ADI were included and stratified in quintiles. Chi-square and Kruskal-Wallis tests were used for analysis. Results: We included 1130 patients who enrolled in a trial; 10 patient refused enrollment 0.9%. Trial participation by gender was similar: 50.5% female and 49.5% male. Race included White 93.5%, African American 5.7% and Asian 0.71% patients. Hispanics made 0.5% of the cohort. When assessed by national ADI, 45% of clinical trial participants were in the highest ADI quintile. When assessed by ADI state ranking, there was similar distribution in trial enrollment. Enrollment at the national and state levels were significant for age (p < 0.001, for both) and race (p = 0.003 and 0.023, respectively). Conclusions: Prior studies have shown that low SES is a barrier trial enrollment; however, this study demonstrates that using a granular measure of SED at the state level, GI and lung cancer clinical trial enrollment has similar distribution by ADI quintiles. But, when assessed at the national level, 45% of trial participants were in the highest SED quintile. This highlight the importance of state and national-level comparisons for SED and suggest that future research is needed to identify barriers and facilitators of cancer clinical trial enrollment. [Table: see text]