A cancer clinic in Memphis, Tennessee made significant strides in ensuring that medical research accurately reflects the diversity of the population. West Cancer Center & Research Institute has achieved remarkable success in enrolling Black patients in their clinical trials, with Black participants making up to 50% of their trial population. This is roughly five times the national average of Black patient participation in medical studies, highlighting a critical effort to address long-standing disparities in healthcare research.
The push for greater Black representation in clinical trials is rooted in a fundamental truth: if Black individuals are not included in these studies, the treatments developed may not be as effective for them. This is because factors like genetics, family medical history, and even environmental and economic conditions can influence how a medicine works. Yoriann Hull, a clinical research coordinator at West Cancer Center, told MLK50 about the need for genomic data from African Americans to be included in databases used for developing treatments. “If we’re not there,” Hull states, “we end up suffering in the long run”.
Historically, clinical trials have predominantly involved white men, leading to treatments that are often better tailored to this group. A clear example of this is seen in some early beta-blocker drugs, which were less effective for many Black individuals, potentially leading to preventable deaths. More recent testing with Black patients has led to the development of beta-blockers that are more suitable for them. Without diverse participation, the medical community risks creating a healthcare system where certain populations are underserved by the very treatments designed to help them.
Furthermore, a lack of diversity in clinical trials can perpetuate health disparities. When medical interventions are primarily tested on one group, their efficacy and safety for other groups remain largely unknown. This can lead to a delay in effective treatments for underrepresented communities and a continued cycle of health inequities. Diverse clinical trials are crucial for identifying potential side effects or different responses to drugs across various populations, ultimately leading to safer and more effective treatments for everyone.
West Cancer Center’s success isn’t accidental; it stems from a few key practices. According to Dr. Gregory Vidal, a breast cancer specialist and co-director of clinical research at West Cancer, their strategy involves actively asking patients to participate, thoroughly explaining the trials, and selecting trials that align with the needs and interests of their patient population. Andrea Curry, West Cancer’s manager of patient-reported health outcomes, told MLK50 that “Everyone who meets study inclusion criteria…is approached about getting into a trial. Everyone”.
Beyond these initial steps, experts suggest that broader reforms are needed to make diverse enrollment the norm rather than an exception. Michelle Martin, co-director of the University of Tennessee Health Sciences Center-based Tennessee Clinical and Translational Science Institute, points out that many clinical trials operate during typical 9-to-5 business hours, which can be a barrier for individuals with different life circumstances.
Recent research also indicates that Black patients are more likely to participate in a clinical trial when Black researchers are involved in conducting it. West Cancer Center has embraced this idea by listing all members of its multiracial staff of physicians as co-investigators on medical trials. This move is part of a larger effort to build trust, as patients are more likely to have confidence in recommendations from trusted healthcare providers.
Beyond race, factors such as a person’s lived circumstances and experiences can impact their ability to participate in trials. This includes environmental and economic conditions, income, occupation, access to healthcare, and reliable transportation. Michael Sheffield, a health industry executive who has participated in several clinical trials, suggests that the health industry needs to adjust its messaging and recruitment strategies. He proposes recruiting in places where Black people frequent, like Historically Black Colleges and Universities (HBCUs), and effectively explaining the benefits of participation, including potential stipends.
Andrea Curry’s own experience highlights the importance of not prejudging patients. According to MLK50, she learned this lesson when an elderly Black woman, whom she initially thought would decline participation in a cellphone app-based study, revealed herself to be proficient with an iPhone and Apple Watch. Curry’s takeaway is crucial: “I’ve learned to never discredit anyone. I approach every single one of them with the same intensity and joy and respect. If you want to increase your recruitment, give everyone a fair chance”.
By actively seeking diverse participants and addressing the systemic barriers that have historically excluded certain groups, clinics like West Cancer Center are paving the way for a more equitable and effective future in medicine.
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