Background: There are known disparities in cancer-related clinical trial participation within the oncology community, including disparities by race/ethnicity, age at cancer diagnosis, education, and obesity status. Our study examines the… Click to show full abstract
Background: There are known disparities in cancer-related clinical trial participation within the oncology community, including disparities by race/ethnicity, age at cancer diagnosis, education, and obesity status. Our study examines the associations between these factors and cancer clinical trial participation among a diverse population of female cancer survivors living in Maryland- a racially and socioeconomically diverse state that is a significant resource to research cancer health disparities. Methods: The Maryland Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing telephone-based disease surveillance program that collects data on lifestyle factors, health status, and healthcare access. The Maryland BRFSS takes a sample of ~15,000 non-institutionalized Maryland residents (≥18 years) per year and includes state-specific modules, including a cancer survivorship module to elicit responses among respondents who indicated they had a past or current cancer diagnosis. This study restricted data to female cancer survivors who participated in the Maryland BRFSS in 2011, 2013, 2015, 2017, 2019, and 2020. Maryland BRFSS respondents who reported having more than one type of cancer, did not report the type of cancer diagnosed, or had skin cancer except for melanoma were not eligible for the study. Weighted multivariable logistic regression models were constructed to examine the associations between risk factors (race/ethnicity, education, age at diagnosis, obesity, and cancer type) and odds of clinical trial participation, determined by the yes/no response to the question, “Did you participate in a clinical trial as a part of your cancer treatment?” Results: A total of 1,633 female cancer survivors were included in the analysis (1,353 non-Hispanic White (NHW); 280 non-Hispanic Black (NHB)). The average age at cancer diagnosis among the respondents was 55 years (SD=16 years), with breast cancer as the most common cancer diagnosis (41.1%). A total of 489 women reported being obese. Only 5.8% of the respondents reported participating in a clinical trial for their cancer treatment; this response differed by race/ethnicity (5.1% of NHW vs 8.9% of NHB; χ2 p= 0.01). NHB women were 2.57 times more likely to participate in a clinical trial (95% confidence intervals (CI): 1.19, 5.53) compared to NHW women. Women with breast cancer were 3.19 times more likely (95% CI: 1.55, 6.56) to participate compared to women with other cancer types. Lastly, women who reported obesity at survey were less likely (adjusted odds ratio: 0.41; 95% CI: 0.19, 0.88) to participate compared to non-obese women. Associations between age at cancer diagnosis (≥50 years vs <50 years), education (college graduate vs. not), and clinical trial participation were not statistically significant. Conclusions: Our results demonstrate that among Maryland female residents with a history of cancer, NHB women were more likely to participate in clinical trials for their cancer treatment, compared with NHW women. We also found significant associations with cancer type, obesity, and odds of clinical trial participation. Our study findings should be interpreted with consideration of the study limitations, including not having the ability to ascertain the respondents’ eligibility and/or their invitation to participate in clinical trials during their cancer treatment. Citation Format: Avonne E. Connor, Kate E. Dibble, Mu Jin. Factors associated with clinical trial participation among female cancer survivors in Maryland [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB139.
               
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