Young Cancer Patients Have Low Clinical Trial Participation

Uninsured, older adults, those treated by nonpediatric oncologist less likely to enroll in trials

TUESDAY, Sept. 20 (HealthDay News) -- Participation in clinical trials is low among adolescent and young adult (AYA) patients with cancer, with uninsured, older patients, or those treated by nonpediatric oncologists less likely to participate, according to a study published online Sept. 19 in the Journal of Clinical Oncology.

Helen M. Parsons, M.P.H., from the National Cancer Institute in Bethesda, Md., and colleagues identified current trends in AYA care by evaluating clinical trial participation patterns, time to treatment, and provider characteristics in a population-based sample of 1,358 AYA patients (aged 15 to 39 years) with cancer. Participants with Hodgkin's lymphoma; non-Hodgkin's lymphoma; acute lymphoblastic leukemia (ALL); germ cell cancer; and osteo-, Ewing, or synovial sarcomas (sarcoma) were identified through the Surveillance, Epidemiology, and End Results Program.

The investigators found that 14 percent of the AYA patients had enrolled in a clinical trial. Trial participation varied with type of cancer, with those diagnosed with ALL and sarcoma showing the highest participation (37 and 32 percent, respectively). Multivariate analyses revealed that participants who were uninsured, older, or treated by nonpediatric oncologists were less likely to enroll in a clinical trial. Though the average time from pathologic confirmation to first treatment was three days, it varied with the site of cancer, and race/ethnicity. Only outpatient treatment and advanced cancer stage correlated with a longer time from pathologic confirmation to treatment in multivariate analyses.

"These findings support the continued need to improve access to clinical trials and innovative treatments for this population, which may ultimately translate into improved survival," the authors write.

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