Clinical trials play a key role in advancing cancer treatment, especially for Black Americans who face higher death rates and experience inequities in access to healthcare. Understanding the unique barriers to clinical trial participation that Black patients in the U.S. face is crucial for better representation.
A survey conducted in partnership with the Association of Community Care Centers (ACCC), the Oncology Research Institute (ACORI), and the American Society of Clinical Oncology (ASCO) aimed to identify barriers to clinical trial participation among Black people and to explore strategies to overcome them.
The Barriers to Clinical Trial Implementation Among Community Care Centers study revealed key factors influencing patient enrollment in clinical trials and recommendations to improve practices and boost enrollment.
This study’s recommendations align with FDA guidance to improve clinical trial enrollment among minority groups. The study also revealed the additional barriers to clinical trial participation:
The majority of enrollments in clinical trials come directly from patient requests to join. However, despite being proactive, patients change their minds about participation for a variety of reasons. These can include a lack of communication with their doctor, fear of negative side effects, concerns based on hearsay or previous experience, whether the trials are culturally appropriate for Black people, and financial or logistical issues.
Because of this, it’s important to capitalize on patients’ proactive behavior by supporting patient-driven programs like the Clinical Trials Matching Service, which, from 2007 to 2010, led to an 11 percent improvement in clinical trial enrollment.
For community care sites not engaged in clinical trial research — six site contacts out of the 58 that responded to the survey — limited staffing was the most common reason for non-participation. This highlights a need to develop better infrastructure to ensure that the necessary resources and support are in place to expand clinical research trial participation efforts.
One of the most pronounced barriers to clinical trial participation, according to the study, was the lack of provider involvement. The study found that some doctors prefer to work with established cancer therapies, while others noted that they simply lacked the time or incentive to discuss trials with their patients. Recommendations to combat these challenges include improving enrollment eligibility criteria and emphasizing reimbursement options for sites conducting trials.
Study results show that location can affect trial availability. Centers with fewer patients and those in rural or suburban areas have fewer industry-sponsored clinical trials than their urban counterparts. To boost clinical trial enrollment, expanding early-phase trials to rural and suburban areas and highlighting industry-sponsored trial enrollment in centers with fewer patients is key.
Clinical trials provide healthcare professionals with important insight into patient care and treatment. With each phase, clinical trials help increase knowledge to assist medical teams in ongoing treatment plans. Research gained from these trials – conducted in a structured, controlled environment – can significantly impact not only current patients but also future patients facing similar conditions and diseases.
Clinical trials also provide patients with access to therapies and treatments that may otherwise be unavailable through standard care. The goal of these trials is to improve treatment effectiveness while minimizing side effects, with the aim of improving patients’ quality of life.
For Black patients with cancer, participating in a research trial comes with the knowledge that not only are they potentially treating their disease, but they’re also helping the medical industry and developing potential cutting-edge treatments that could improve the lives of other Black Americans.
Historically, clinical trials have had inconsistencies regarding making sure treatments align with the unique needs of Black patients facing numerous health issues in comparison to their non-Black counterparts.
To promote equitable medical access, clinical trials must reflect the groups impacted by the conditions or diseases being treated and studied. Because Black Americans are disproportionately diagnosed with certain late-stage cancers, clinical trials are of utmost importance.
Factors such as race, socioeconomic status, and location not only affect a person’s risk of developing certain types of cancers, but they can also be a factor in treatment and their chances of survival. With more Black cancer patients participating in clinical trials, more data on how to care for Black patients specifically becomes available.
To learn more about clinical trials, visit our Clinical Trials Resource Center.
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