Disparities in Prostate Cancer Clinical Trials by County

A study presented during the 2021 ASCO Annual Meeting observed county-level racial disparities in access to prostate cancer clinical trials.

Using prostate cancer clinical trial data from the Aggregate Analysis of ClincalTrials.gov coupled with county-level socioeconomic, demographic, and healthcare facility data, the study authors constructed a county-level database for their analysis. They examined the correlation between the percent of African Americans (AAs) in the county and access to National Cancer Institute–designated cancer facilities. They then assessed counties with cancer facilities to determine the correlation between the percentage of AAs in the county and the number of available prostate cancer treatment trials per capita per year.

Final analysis included 613 prostate cancer trial sites among 3,145 U.S. counties. Counties with higher proportions of AAs had a lower likelihood of having cancer facilities (adjusted odds ratio, 0.85). When looking at counties with cancer facilities, there were much fewer prostate cancer trials per capita annually in counties with higher percentage of AAs (rate ratio per 10% increase in AAs, 0.90), even after adjusting for county-level sociodemographic and healthcare system factors.

“Clinical trials in prostate cancer therapy should ensure adequate availability of enrollment sites in regions with high concentrations of AAs,” the study authors recommended in their conclusion.