TY - JOUR
T1 - Participation of the elderly population in clinical trials
T2 - Barriers and solutions
AU - Denson, Aaron C.
AU - Mahipal, Amit
PY - 2014/7
Y1 - 2014/7
N2 - Background: Despite the fact that cancer disproportionately affects the elderly, most participants of clinical cancer trials are relatively young. This misrepresentation greatly affects the oncology treatment of the elderly population (> 65 years of age). Few studies have attempted to identify the problems related to discrepancy based on age for clinical trial participation. Methods: A literature review was performed to identify barriers and solutions to enrollment of elderly persons for clinical cancer trials. Results: Physician-related barriers include perception about treatment tolerance, drug metabolism, a lack of evidence for efficacy, and age bias. Lack of autonomy, concerns about quality of life and toxicities, accessibility to clinical trials, and logistical and financial difficulties are common patient-related barriers. Trial-related barriers include eligibility criteria based on performance status, organ dysfunction, and the presence of comorbidities. Solutions, such as improved communication, and coordinating logistical challenges may help overcome some of these challenges. Studies designed for the geriatric population could modify the perception and behavior of health care professionals and improve patient participation in clinical trials. Conclusions: Implementing some of these solutions and increased research may help overcome shortfalls in elderly enrollment, thus allowing for more effective treatment of older patients.
AB - Background: Despite the fact that cancer disproportionately affects the elderly, most participants of clinical cancer trials are relatively young. This misrepresentation greatly affects the oncology treatment of the elderly population (> 65 years of age). Few studies have attempted to identify the problems related to discrepancy based on age for clinical trial participation. Methods: A literature review was performed to identify barriers and solutions to enrollment of elderly persons for clinical cancer trials. Results: Physician-related barriers include perception about treatment tolerance, drug metabolism, a lack of evidence for efficacy, and age bias. Lack of autonomy, concerns about quality of life and toxicities, accessibility to clinical trials, and logistical and financial difficulties are common patient-related barriers. Trial-related barriers include eligibility criteria based on performance status, organ dysfunction, and the presence of comorbidities. Solutions, such as improved communication, and coordinating logistical challenges may help overcome some of these challenges. Studies designed for the geriatric population could modify the perception and behavior of health care professionals and improve patient participation in clinical trials. Conclusions: Implementing some of these solutions and increased research may help overcome shortfalls in elderly enrollment, thus allowing for more effective treatment of older patients.
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U2 - 10.1177/107327481402100305
DO - 10.1177/107327481402100305
M3 - Article
C2 - 24955704
AN - SCOPUS:84903163207
SN - 1073-2748
VL - 21
SP - 209
EP - 214
JO - Cancer Control
JF - Cancer Control
IS - 3
ER -