University of Maryland School of Medicine Baltimore, MD
C. Gomez1, K. Baker2, C. Eggleston2, M. J. Ferris2, J. K. Molitoris2, Z. H. Rana2, S. A. McAvoy2, E. M. Nichols2, W. F. Regine Jr2, S. M. Bentzen2,3, and M. A. L. Vyfhuis2; 1University of Maryland School of Medicine, Baltimore, MD, 2Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, 3Department of Epidemiology and Public Health, Biostatistics and Bioinformatics Division, University of Maryland School of Medicine, Baltimore, MD
Purpose/Objective(s): Despite national mandates to increase participation of underrepresented racial and ethnic minorities in clinical trials, successful recruitment of these marginalized groups remains low. There has been a recent decline in Black participant (BP) enrollment in cancer-related clinical trials and the etiology remains poorly understood. Therefore, we aim to characterize key psychosocial factors that patients with curative gastrointestinal, thoracic, gynecological, and head and neck malignancies consider when enrolling in a research study, with the goal of improved recruitment of Black patients. Materials/Methods: We conducted a cross-sectional, descriptive study using a questionnaire adapted from two previously validated surveys to patients who completed definitive radiation treatment for the aforementioned malignancies. The investigation took place at two study sites in an academic, university medical system. Chi-square tests and Mann-Whitney U test were used to assess associations or differences between the populations.
Results: From October 2023 to February 2024, 138 eligible patients were asked to participate, and 97 patients agreed (compliance 70%). BP comprised 30% of the patient population (n=42), predominantly women (47.4%v69%; p=0.019), were less likely to be married (37%v74%; p=0.002), but more likely to, live with family (33.3%v12.7%; p=0.004), have a lower median income ($69,318vs.$111,376; p<0.001), a larger mean Charlson comorbidity index (CCI; 3.63vs.2.80; p=0.017), when compared to non-Black patients (NBP). There was no difference in insurance status, education, employment status, cancer stage or treatments rendered between the two cohorts. Both groups were equally asked to participate in a clinical trial (BPvs.NBP; 16%vs.18%; p=NS). Yet, BP were more apt to agree with statements that illness/death is determined by God’s will, (55.5%vs.10%; p=0.001) and that God determines wellness, not research (59.1%vs.11.6%; p<0.001) when compared to NBP. Twenty percent of BP agreed that research harms minorities vs. 0% of NBP (p<0.001) and one-third of BP think that research will provide more information about their health that they would rather no know about (vs.4%; p=0.037). BP felt that there was nothing for them (20%vs.2%; p=0.038) or their community (40%vs.6%; p=0.031) to gain by participating in research when compared to the NBP. =90% of both groups agreed that they trust their cancer doctors.
Conclusion: Our preliminary data suggests the importance of spiritual themes within the Black community when considering clinical trials. Though most patients trust their cancer care team, there remains underlying distrust in clinical research among Black patients. We are further characterizing these factors through focus groups, with a goal of designing interventions, particularly for patients of color.
