Structural, Clinical Barriers Prevent Cancer Trial Participation
WEDNESDAY, Feb. 20, 2019 -- Structural and clinical barriers prevent most cancer patients from participating in clinical trials, according to a review published online Feb. 19 in the Journal of the National Cancer Institute.
Joseph M. Unger, Ph.D., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues conducted a systematic review and meta-analysis to examine the magnitude of different trial barrier domains. Structural (trial availability), clinical (eligibility), and patient/physician barrier domains were characterized and quantified using a uniform framework. Thirteen studies with 8,883 patients were identified.
The researchers found that 55.6 percent of the time, a trial was unavailable for patients at their institution. In addition, 21.5 and 14.8 percent of patients were ineligible for an available trial or did not enroll, respectively; 8.1 percent enrolled. The rates of trial enrollment differed in academic and community settings (15.9 versus 7 percent); the rates of trial unavailability, ineligibility, or nonenrollment did not differ.
"These findings illustrate the need to re-examine the way we think about patient participation in clinical trials," Unger said in a statement. "Most of the time it's not up to the patient. Instead, structural and clinical barriers are the reasons more than three out of four patients do not participate in trials."
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Posted: February 2019