"Only 3% of adult cancer patients in the U.S.

participate in clinical trials - far fewer

than the number needed to answer the most pressing cancer questions quickly."

Reflecting on the quote above, why do you think more people don't participate in
clinical trials?

● Explain and support your answer with at least one reference.

Clinical research trials are one of the most important tools that can be used to advance
the healthcare field and improve treatment success.1 In order to perform these trials,
researchers must seek approval from oversight boards such as the IRB, and other
oncologic groups, like the RTOG, for support and guidance throughout the research
process. This is the first step to performing research, and is done to ensure the study
will actually provide useful clinical information as well and protect the rights and safety
of the participants. Without willing participants in the past, we would most definitely not
be where we are today in regards to scientific discovery. As the quote above says, just a
small fraction of the people who are battling cancer will participate in research.
To provide some further explanation to the quote, over half a million people will die of
cancer each year, in the United States. This is about 30 percent of the 1.9 million people
who are diagnosed with cancer each year. It seems, from a healthcare worker
viewpoint, that joining a clinical trial is a no brainer, but patients have a different
perspective that we must consider. Researchers from the Medical University of South
Carolina created a journal article that answers the question of why more people do not
participate in research trials. The most common barriers they discussed are fear, trouble
communicating with medical personnel, insurance issues, transportation difficulties, and
perceptions about the provider's treatment.2 One interesting factor to consider is that
only 20 percent of cancer patients are even eligible for clinical trials.2 Of this subgroup,
15-25 percent choose to participate in research trials (providing us with the 3-5 percent
figure mentioned in the quote). Some interesting patterns arise as you further divide the
population into groups based on race, sex, and age. The researchers found a trend that
the older a patient is, the less likely they are to participate in a clinical trial. Men are
nearly twice as likely to participate in clinical trials as women. African Americans and
Hispanics are nearly half as likely to participate in clinical trials as Caucasians. This
variance was explained by a distrust of research trials due to historical mistreatment
(discussed in week 1).2
It is our responsibility, on behalf of our patients, and for the good of the scientific
community, to address these barriers.1 In this study, the researchers stated that when
the barriers were addressed and removed, the individuals were more likely to
participate.2 One method that was used to address these barriers was to assign each
patient a navigator. The navigator was responsible for educating the patient, arranging
temporary housing and transportation, and was the middleman between the patient and
the physician. Providing these services and reducing the expenditures incurred by the
patients made them more comfortable and willing to participate in the clinical trial. This
is a good system that should be more widely implemented in order to improve patient
care and make new advancements in the field of radiation oncology.

References

1. Clinical Trials. [SoftChalk]. La Crosse, WI: UW-L Medical Dosimetry Program;

2022.
2. Cartmell KB, Bonilha HS, Simpson KN, Ford ME, Bryant DC, Alberg AJ. Patient
barriers to cancer clinical trial participation and navigator activities to assist. Adv
Cancer Res. 2020;146:139-166. doi:10.1016/bs.acr.2020.01.008