Access Denied: Inequities in Pancreatic Cancer Clinical Trial Enrollment

This article was originally published here

Ann Surg Oncol. October 16, 2021. doi: 10.1245 / s10434-021-10868-4. Online ahead of print.

ABSTRACT

Background: The influence of social determinants of health (SDH) on participation in pancreatic cancer clinical trials is not well understood. In this study, we describe trends and identify disparities in the recruitment of pancreatic cancer clinical trials.

PATIENTS AND METHODS: This is a retrospective study of patients with stage I-IV pancreatic cancer in the National Cancer Database 2004-2016. The cohort was stratified between those enrolled in clinical trials during the first cycle of treatment versus those not enrolled. Bivariate analysis and logistic regression were used to understand the relationship between SDH and clinical trial participation.

RESULTS: A total of 1127 patients (0.4%) enrolled in clinical trials versus 301,340 (99.6%) not enrolled. Recruitment increased over the study period (p 21%).

DISCUSSION: Age, race, insurance and geography are barriers to enrolling in clinical trials for patients with pancreatic cancer. While overall recruitment has increased, black patients and patients on Medicaid remain under-represented. After adjusting for cancer-specific factors, SDH is still associated with enrollment in clinical trials, suggesting the need for targeted interventions.

PMID: 34655352 | DOI: 10.1245 / s10434-021-10868-4


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