Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review

Jean G. Ford, Mollie W. Howerton, Gabriel Y. Lai, Tiffany L. Gary, Shari Bolen, M. Chris Gibbons, Jon C Tilburt, Charles Baffi, Teerath Peter Tanpitukpongse, Renee F. Wilson, Neil R. Powe, Eric B. Bass

Research output: Contribution to journalArticle

430 Citations (Scopus)

Abstract

Racial and ethnic minorities, older adults, rural residents, and individuals of low socioeconomic status are underrepresented among participants in cancer-related trials. The authors conducted a systematic review to determine the barriers to participation of underrepresented populations in cancer-related trials. Their search included English-language publications that reported original data on the recruitment of underrepresented groups to cancer treatment or prevention trials between 1966 and December 2005 in multiple electronic databases. They also hand-searched titles in 34 journals from January 2003 to December 2005 and they examined reference lists for eligible articles. Titles and abstracts were reviewed to identify relevant studies. Data on barriers to participation were synthesized both qualitatively and based on statistically significant associations with trial enrollment. Of 5257 studies that were cited, 65 studies were eligible for inclusion in the current analysis, including 46 studies on recruitment into cancer therapeutic trials, 15 studies on recruitment into prevention trials, and 4 studies on recruitment into both prevention and treatment trials. Numerous factors were reported as barriers to participation in cancer-related trials. However, only 20 of the studies reported statistically significant associations between hypothesized barriers and enrollment. The available evidence had limitations in quality regarding representativeness, justification of study methods, the reliability and validity of data-collection methods, potential for bias, and data analysis. The results indicate that underrepresented populations face numerous barriers to participation in cancer-related trials. The current systematic review highlighting the literature on recruitment of underrepresented populations to cancer trials and may be used as the evidence base toward developing an agenda for etiologic and intervention research to reduce the disparities in participation in cancer-related trials.

Original languageEnglish (US)
Pages (from-to)228-242
Number of pages15
JournalCancer
Volume112
Issue number2
DOIs
StatePublished - Jan 15 2008
Externally publishedYes

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Keywords

  • Clinical trials
  • Health disparities
  • Racial/ethnic minority populations
  • Recruitment
  • Systematic review
  • Underrepresented populations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ford, J. G., Howerton, M. W., Lai, G. Y., Gary, T. L., Bolen, S., Gibbons, M. C., ... Bass, E. B. (2008). Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review. Cancer, 112(2), 228-242. https://doi.org/10.1002/cncr.23157

Barriers to recruiting underrepresented populations to cancer clinical trials : A systematic review. / Ford, Jean G.; Howerton, Mollie W.; Lai, Gabriel Y.; Gary, Tiffany L.; Bolen, Shari; Gibbons, M. Chris; Tilburt, Jon C; Baffi, Charles; Tanpitukpongse, Teerath Peter; Wilson, Renee F.; Powe, Neil R.; Bass, Eric B.

In: Cancer, Vol. 112, No. 2, 15.01.2008, p. 228-242.

Research output: Contribution to journalArticle

Ford, JG, Howerton, MW, Lai, GY, Gary, TL, Bolen, S, Gibbons, MC, Tilburt, JC, Baffi, C, Tanpitukpongse, TP, Wilson, RF, Powe, NR & Bass, EB 2008, 'Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review', Cancer, vol. 112, no. 2, pp. 228-242. https://doi.org/10.1002/cncr.23157
Ford JG, Howerton MW, Lai GY, Gary TL, Bolen S, Gibbons MC et al. Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review. Cancer. 2008 Jan 15;112(2):228-242. https://doi.org/10.1002/cncr.23157
Ford, Jean G. ; Howerton, Mollie W. ; Lai, Gabriel Y. ; Gary, Tiffany L. ; Bolen, Shari ; Gibbons, M. Chris ; Tilburt, Jon C ; Baffi, Charles ; Tanpitukpongse, Teerath Peter ; Wilson, Renee F. ; Powe, Neil R. ; Bass, Eric B. / Barriers to recruiting underrepresented populations to cancer clinical trials : A systematic review. In: Cancer. 2008 ; Vol. 112, No. 2. pp. 228-242.
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abstract = "Racial and ethnic minorities, older adults, rural residents, and individuals of low socioeconomic status are underrepresented among participants in cancer-related trials. The authors conducted a systematic review to determine the barriers to participation of underrepresented populations in cancer-related trials. Their search included English-language publications that reported original data on the recruitment of underrepresented groups to cancer treatment or prevention trials between 1966 and December 2005 in multiple electronic databases. They also hand-searched titles in 34 journals from January 2003 to December 2005 and they examined reference lists for eligible articles. Titles and abstracts were reviewed to identify relevant studies. Data on barriers to participation were synthesized both qualitatively and based on statistically significant associations with trial enrollment. Of 5257 studies that were cited, 65 studies were eligible for inclusion in the current analysis, including 46 studies on recruitment into cancer therapeutic trials, 15 studies on recruitment into prevention trials, and 4 studies on recruitment into both prevention and treatment trials. Numerous factors were reported as barriers to participation in cancer-related trials. However, only 20 of the studies reported statistically significant associations between hypothesized barriers and enrollment. The available evidence had limitations in quality regarding representativeness, justification of study methods, the reliability and validity of data-collection methods, potential for bias, and data analysis. The results indicate that underrepresented populations face numerous barriers to participation in cancer-related trials. The current systematic review highlighting the literature on recruitment of underrepresented populations to cancer trials and may be used as the evidence base toward developing an agenda for etiologic and intervention research to reduce the disparities in participation in cancer-related trials.",
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