Lower income cancer patients less likely to be involved in clinical trials

June 03, 2012

ANN ARBOR, MICH. -- Cancer patients with annual household incomes below $50,000 were less likely to participate in clinical trials than patients with annual incomes of $50,000 or higher, and were more likely to be concerned about how to pay for clinical trial participation. This is the conclusion of a large study by the SWOG cancer research cooperative group that will be presented at the annual meeting of the American Society for Clinical Oncology (ASCO) in Chicago this week.

The study was a collaboration between SWOG, supported largely by the National Cancer Institute (NCI), and NexCura, which until the recent sale of that company had run an online treatment decision tool that many cancer advocacy organizations made available to patients via their websites.

Led by Joseph M. Unger, M.S., Ph.C., of the SWOG Statistical Center and the Fred Hutchinson Cancer Research Center in Seattle, the study surveyed 5,499 patients who registered with NexCura's treatment decision tool.

In the end, 7.6 percent of survey takers with an annual income below $50,000 reported participating in clinical trials, while 10.0 percent of those with incomes of $50,000 or more said they took part.

Lower levels of participation are concerning on at least two fronts, says Unger. "From the patient perspective, since clinical trials offer state of the art therapy, lower income patients may not have equal access to this important medical resource."

On a broader scientific level, Unger argues that increasing participation rates of lower income patients in clinical trials would give doctors and researchers greater confidence that the results of those trials apply to patients across the income spectrum. In addition, with more patients participating in clinical trials, trials could be done more quickly, ultimately speeding the development of new treatments for cancer patients.

The researchers found that lower income patients were more likely to be concerned about how to pay for the care they would receive as part of a clinical trial. Unger proposes that although past research has shown that patient care costs for clinical trials are not appreciably higher than for non-trial treatments, lower income patients may still be more concerned about co-pays and co-insurance than higher income patients. Also, lower income patients may be more affected by the indirect or hidden costs of clinical trial participation, such as having to take time off work to go to a clinic visit. The researchers suggest that further research is needed to identify the specific cost concerns that may be limiting participation for lower income patients.

Because income data are not generally collected from patients when they start treatment, previous studies that looked at socioeconomic status and trial participation often included surrogate measures to infer income level; for example, median income level from the patient's zip code region was used to estimate individual patient income. Those earlier studies hinted at this correlation, but tended to be less reliable as evidence.

Unger notes that, "This is the biggest study to use patient-level income on a national level that also accounts for patient medical conditions." He emphasizes the importance of the comorbidity factor because lower income patients are more likely to suffer from a range of health conditions that might limit their eligibility for trials. This study was able to control for these differences in health status, yet the difference in participation rates by income level remained.
-end-
Additional authors: D Hershman, KS Albain, C Moinpour, J Petersen, K Burg, JJ Crowley

Funding: National Cancer Institute; NexCura

Disclosure: None

Reference: Unger, JM et al. "Patterns of Decision-Making about Cancer Clinical Trial Participation among the Online Cancer Treatment Community: A collaboration between SWOG and NexCura®." American Society of Clinical Oncology Annual Meeting, June 1-5, 2012, Chicago, abstract No. 6009.

About the SWOG clinical trials network:

SWOG is one of the five cooperative groups that together comprise the National Cancer Institute's (NCI's) National Clinical Trials Network. The group designs and conducts multidisciplinary clinical trials to improve the practice of medicine in preventing, detecting, and treating cancer, and to enhance the quality of life for cancer survivors. The more than 4,000 researchers in the group's network practice at more than 500 institutions, including 22 of the NCI-designated cancer centers as well as cancer centers in almost a dozen other countries. Formerly the Southwest Oncology Group, SWOG is headquartered at the University of Michigan in Ann Arbor (734-998-7140) and has an operations office in San Antonio and a statistical center in Seattle. Learn more at swog.org.

SWOG - Leading cancer research. Together.

University of Michigan Health System

Related Clinical Trials Articles from Brightsurf:

Nearly 1 in 5 cancer patients less likely to enroll in clinical trials during pandemic
A significant portion of cancer patients may be less likely to enroll in a clinical trial due to the ongoing coronavirus pandemic.

COVID-19 clinical trials lack diversity
Despite disproportionately higher rates of COVID-19 infection, hospitalization and death among people of color, minority groups are significantly underrepresented in COVID-19 clinical trials.

Why we should trust registered clinical trials
In a time when we have to rely on clinical trials for COVID-19 drugs and vaccines, a new study brings good news about the credibility of registered clinical trials.

Inclusion of children in clinical trials of treatments for COVID-19
This Viewpoint discusses the exclusion of children from coronavirus disease 2019 (COVID-19) clinical trials and why that could harm treatment options for children.

Review evaluates how AI could boost the success of clinical trials
In a review publishing July 17, 2019 in the journal Trends in Pharmacological Sciences, researchers examined how artificial intelligence (AI) could affect drug development in the coming decade.

Kidney patients are neglected in clinical trials
The exclusion of patients with kidney diseases from clinical trials remains an unsolved problem that hinders optimal care of these patients.

Clinical trials beginning for possible preeclampsia treatment
For over 20 years, a team of researchers at Lund University has worked on developing a drug against preeclampsia -- a serious disorder which annually affects around 9 million pregnant women worldwide and is one of the main causes of death in both mothers and unborn babies.

Underenrollment in clinical trials: Patients not the problem
The authors of the study published this month in the Journal of Clinical Oncology investigated why many cancer clinical trials fail to enroll enough patients.

When designing clinical trials for huntington's disease, first ask the experts
Progress in understanding the genetic mutation responsible for Huntington's disease (HD) and at least some molecular underpinnings of the disease has resulted in a new era of clinical testing of potential treatments.

New ALS therapy in clinical trials
New research led by Washington University School of Medicine in St.

Read More: Clinical Trials News and Clinical Trials Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.