Lower income reduces participation in cancer clinical trials

In a carefully documented study, sponsored and funded by the National Cancer Institute and NexCura, researchers found a surprising gap in participation in clinical trials between cancer patients with higher incomes and those with lower incomes. Nearly 5,500 cancer patients were interviewed for the study that concludes:

• Cancer patients with annual incomes under $50,000 were 27% less likely to participate in a clinical trial than those with an annual income of more than $50,000.
• Cancer patients with an annual income under $20,000 (such as many living on Social Security) were 44% less likely to participate in a clinical trial than those with an annual income of more than $50,000. Concern over possible costs was given a major factor in their decision not to participate (including co-pays, time off work, etc.).

Does this matter from a scientific/research point of view?

Researchers say yes.

• Lower participation rates in the lower income groups results in lower overall participation rates and slows the rate of completing trials and ultimately getting FDA approval for new and better treatments.
• With lower participation rates from large segments of the population trial results may not be as reliable, their results may not be fully applicable to all populations.

Does it matter from a patient point of view?

• Clinical trials can provide many benefits to participants, including access to new drugs, excellent medical treatment, and close monitoring of their health status.
• According to the study leader, Dr. Joseph M. Unger, lower income individuals already have more medical conditions and less access to healthcare than their higher income peers. Having less access to cancer clinical trials adds to this treatment gap.

Solutions?

The study recommended:

• Increased and improved education for lower income cancer patients, making sure they knew what the costs were and that costs associated with clinical trials were not significantly different from regular care.
• Increased and improved education for lower income cancer patients about the possible benefits of participating in cancer clinical trials.

Other possibilities…

• Providing transportation or transportation costs for low income participants.
• Providing the trial treatment in the participant’s home (going to them).
• Finding ways to include (more) lower income individuals who do not have health insurance coverage.

In an ideal world, all patients would have equal access to cancer clinical trials. 

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(c) 2012 Tom Beer and Larry Axmaker