The Influence of Race on the Attitudes of Radiation Oncology Patients Towards Clinical Trial Enrollment

Reviewer: Christopher Dolinsky, MD
OncoLink
Last Modified: October 4, 2004

Presenter: Charles Wood, MD
Presenter's Affiliation: Hospital of the University of Pennsylvania
Type of Session: Scientific

Background

Without the participation of patients in clinical trials, the ideal treatment approaches for a variety of diseases cannot be optimized.
Because only 2-3% of patients diagnosed with a particular disease enroll in clinical trials, the information gathered may not be generalizable to the entire population.
Enrollment in clinical trials is particularly low for minority populations, and a paucity of information exists regarding minority attitudes towards clinical trial enrollment.

Materials and Methods

Between February and September of 2003, an internally validated questionnaire designed to assess patient's attitudes towards clinical trials was distributed to every new patient in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center.
All 166 patients that were surveyed completed the questionnaire.
65% of the patients surveyed were Caucasian, and African Americans made up the majority of the other 35%.
The most common cancer diagnoses in order were: prostate cancer, head and neck cancer and breast cancer.

Results

All races had an equal interest in obtaining information about clinical trials
Caucasian patients (when compared with other races) were both more likely to search for clinical trial information on the Internet and more likely to use their physicians as a source of information about clinical trials.
Non-Caucasian patients (when compared with Caucasians) were both more likely to use other patients as a source of information about clinical trials and more likely to believe that they had been previously treated on a clinical trial without their knowledge and permission.
Non-Caucasian patients were more likely to require a greater than 50% chance of a benefit from a clinical trial before they would enroll.
There was no difference between the races in terms of what risk of toxicity they would accept before enrolling on a clinical trial.

Author's Conclusions

Significant differences exist between races in terms of attitudes about clinical trial enrollment.
Minority patients may have an increased level of mistrust toward the medical and scientific community, and this may affect their levels of enrollment.
Physicians need to improve their abilities to explain the realities, risks, and benefits of clinical trial enrollment to all of their patients.

Clinical/Scientific Implications

The manner in which enrollment in clinical trials is discussed with patients of all races must be sensitive to particular patient's underlying fears, concerns and potential distrust of the medical community.
Non-classical methods of enrollment on clinical trials may need to be employed to ensure adequate numbers of minority patients studied.