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Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review
Article first published online: 15 NOV 2007
DOI: 10.1002/cncr.23157
Copyright © 2007 American Cancer Society
Additional Information
How to Cite
Ford, J. G., Howerton, M. W., Lai, G. Y., Gary, T. L., Bolen, S., Gibbons, M. C., Tilburt, J., Baffi, C., Tanpitukpongse, T. P., Wilson, R. F., Powe, N. R. and Bass, E. B. (2008), Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review. Cancer, 112: 228–242. doi: 10.1002/cncr.23157
Publication History
- Issue published online: 4 JAN 2008
- Article first published online: 15 NOV 2007
- Manuscript Accepted: 9 AUG 2007
- Manuscript Revised: 28 JUL 2007
- Manuscript Received: 22 DEC 2006
Funded by
- Agency for Healthcare Research and Quality. Grant Number: 290-02-0018
- National Cancer Institute
- National Institutes of Health
REFERENCES
- 1Institute of Medicine. The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: National Academy Press; 1999.
- 2National Institute of Health. Monitoring Adherence to the NIH Policy on the Inclusion of Women and Minorities as Subjects in Clinical Research. Available at URL: http://www4.od.nih.gov/orwh/GoldReport_2000-01.pdf Accessed October 1, 2004.
- 3National Institute of Health. NIH Policy and Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research—amended October, 2001. Available at URL: http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm Accessed October 1, 2004.
- 4,. Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst. 2002; 94: 334–357.
- 5,,, et al. How sociodemographics, presence of oncology specialists, and hospital cancer programs affect accrual to cancer treatment trials. J Clin Oncol. 2002; 20: 2109–2117.
- 6,. Selection and description of cancer clinical trials participants—science or happenstance? Cancer. 2002; 95: 950–959.Direct Link:
- 7,. Responses to captopril and hydrochlorothiazide in black patients with hypertension. Clin Pharmacol Ther. 1982; 32: 307–312.
- 8,,. What makes clinical research ethical? JAMA. 2000; 283: 2701–2711.
- 9,,, et al. Representation of African-Americans, Hispanics, and whites in National Cancer Institute cancer treatment trials. J Natl Cancer Inst. 1996; 88: 812–816.
- 10,,. A study on recruitment of black Americans into clinical trials through a cultural competence lens. Cancer Nurs. 2000; 23: 444–451; quiz 451–442.
- 11,,,. Racial differences in the treatment of early-stage lung cancer. N Engl J Med. 1999; 341: 1198–1205.
- 12,,,,. Primary care physicians who treat blacks and whites. N Engl J Med. 2004; 351: 575–584.
- 13,,,,,. Survival of blacks and whites after a cancer diagnosis. JAMA. 2002; 287: 2106–2113.
- 14,. Race and research in focus: perspectives on minority participation. In: BettinaM, ed. Health Studies: Clinical Trials. Washington, DC: American Public Health Association; 2004.
- 15,,, et al. Evidence Report on Knowledge and Access to Information on Recruitment of Underrepresented Populations to Cancer Clinical Trials. Evidence Report/Technology Assessment No 05-E019-2 ed. Baltimore, Md: Johns Hopkins University Evidence-based Practice Center; 2005.
- 16GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004; 328: 1490–1497.
- 17,,, et al. Enrollment of African Americans onto clinical treatment trials: study design barriers. J Clin Oncol. 2004; 22: 730–734.
- 18,,, et al. Barriers to the participation of African-American patients with cancer in clinical trials: a pilot study. Cancer. 2003; 97: 1499–1506.Direct Link:
- 19,,,,. Recruitment and retention of economically underserved women to a cervical cancer prevention trial. Appl Nurs Res. 2004; 17: 55–60.
- 20,. Determinants of patient nonparticipation in randomized clinical trials for the treatment of sarcomas. Cancer Clin Trials. 1979; 2: 237–246.
- 21
- 22,,,. Women's feedback on a chemopreventive trial for cervical dysplasia. Appl Nurs Res. 2003; 16: 22–28.
- 23,,, et al. Recruitment strategies for cervical cancer prevention study. Gynecol Oncol. 2002; 85: 250–254.
- 24,,. Children in research: the experience of ill children and adolescents. J Fam Nurs. 2001; 7: 32–49.
- 25,. The influence of relationships on children's and adolescents' participation in research. Nurs Res. 2003; 52: 191–197.
- 26,,,. Recruitment and retention of minority women in cancer screening, prevention, and treatment trials. Ann Epidemiol. 2000; 10( 8 suppl): S13–S21.
- 27,. Willingness to participate in clinical treatment research among older African Americans and whites. Gerontologist. 2003; 43: 62–72.
- 28,,. A comparison of elderly patients with aggressive histology lymphoma who were entered or not entered on to a randomized phase II trial. Leuk Lymphoma. 2000; 38(3–4): 327–334.
- 29,,,,. Public attitudes toward participation in cancer clinical trials. JClin Oncol. 2003; 21: 830–835.
- 30,,, et al. Minority recruitment to the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Clin Trials. 2005; 2: 436–442.
- 31,,, et al. Collaborative Ocular Melanoma Study Group. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, II: characteristics of patients enrolled and not enrolled. COMS Report No. 17. Arch Ophthalmol. 2001; 119: 951–965.
- 32,,,,. Factors that influence Spanish- and English-speaking participants' decision to enroll in cancer randomized clinical trials. Psychooncology. 2006; 15: 273–284.Direct Link:
- 33
- 34,,, et al. Minority recruitment in clinical trials: a conference at Tuskegee, researchers and the community. Ann Epidemiol. 2000; 10( 8 suppl): S35–S40.
- 35,,, et al. Barriers to minority participation in breast carcinoma prevention trials. Cancer. 2005; 104: 374–379.Direct Link:
- 36
- 37,,,. Enrolling older persons in cancer trials: the effect of sociodemographic, protocol, and recruitment center characteristics. J Clin Oncol. 2005; 23: 4755–4763.
- 38,. Impact of managed care on cancer trial enrollment. J Clin Oncol. 2005; 23: 3811–3818.
- 39,,,,. Enrollment of older persons in cancer trials after the Medicare reimbursement policy change. Arch Intern Med. 2005; 165: 1514–1520.
- 40,,,. The impact of socioeconomic status and race on trial participation for older women with breast cancer. Cancer. 2005; 103: 483–491.Direct Link:
- 41,,,. Barriers and facilitators to enrollment in cancer clinical trials: qualitative study of the perspectives of clinical research associates. Cancer. 2002; 95: 1577–1583.Direct Link:
- 42,,, et al. Selection factors in clinical trials: results from the Community Clinical Oncology Program Physician's Patient Log. Cancer Treat Rep. 1987; 71: 559–565.
- 43,,, et al. North Central Cancer Treatment Group. Should elderly non-small-cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the North Central Cancer Treatment Group. J Clin Oncol. 2005; 23: 9113–9119.
- 44,,, et al. Assuring access to state-of-the-art care for U.S. minority populations: the first 2 years of the Minority-Based Community Clinical Oncology Program. J Natl Cancer Inst. 1993; 85: 1945–1950.
- 45,,, et al. Barriers to clinical trial participation by older women with breast cancer. J Clin Oncol. 2003; 21: 2268–2275.
- 46,,. Randomized clinical trials of cancer treatment—a public opinion survey. Clin Oncol. 1984; 10: 155–161.
- 47,,, et al. Improving accrual of older persons to cancer treatment trials: a randomized trial comparing an educational intervention with standard information: CALGB 360001. J Clin Oncol. 2005; 23: 2201–2207.
- 48,,, et al. Survey of oncologists' perceptions of barriers to accrual of older patients with breast carcinoma to clinical trials. Cancer. 2002; 95: 989–996.Direct Link:
- 49,,,. Patterns of enrollment on cooperative group studies. An analysis of trends from the Los Angeles County Cancer Surveillance Program. Cancer. 1993; 71( 10 suppl): 3325–3330.Direct Link:
- 50,,, et al. Prospective evaluation of cancer clinical trial accrual patterns: identifying potential barriers to enrollment. J Clin Oncol. 2001; 19: 1728–1733.
- 51,,, et al. Evaluation of factors affecting awareness of and willingness to participate in cancer clinical trials. J Clin Oncol. 2005; 23: 9282–9289.
- 52,,, et al. Social factors affecting interest in participating in a prostate cancer chemoprevention trial. J Cancer Educ. 1999; 14: 88–92.
- 53,,, et al. Recruiting high risk women into a breast cancer health promotion trial. Cancer Epidemiol Biomarkers Prev. 1994; 3: 271–276.
- 54,,, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol. 2003; 21: 1383–1389.
- 55,,. What influences participation in clinical trials in palliative care in a cancer centre? Eur J Cancer. 2000; 36: 621–626.
- 56,,, et al. Breast cancer prevention in community clinics: will low-income Latina patients participate in clinical trials? Prev Med. 2005; 40: 611–618.
- 57,,, et al. An evaluation of barriers to accrual in the era of legislation requiring insurance coverage of cancer clinical trial costs in California. Cancer J. 2004; 10: 294–300.
- 58,,, et al. Recruiting minority cancer patients into cancer clinical trials: a pilot project involving the Eastern Cooperative Oncology Group and the National Medical Association. J Clin Oncol. 1999; 17: 1029–1039.
- 59
- 60,,. Determinants of participation in state-of-the-art cancer prevention, early detection/screening, and treatment trials among African-Americans. Cancer Nurs. 1993; 16: 25–33.
- 61,,, et al. Minority recruitment in the prostate cancer prevention trial. Ann Epidemiol. 2000; 10( 8 suppl): S85–S91.
- 62,,,,. Barriers to black women's participation in cancer clinical trials. J Natl Med Assoc. 1997; 89: 721–727.
- 63,,. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA. 2004; 291: 2720–2726.
- 64,,, et al. Clinical trial enrollment of rural patients with cancer. Cancer Pract. 2002; 10: 28–35.Direct Link:
- 65,,, et al. Asian Americans and cancer clinical trials: a mixed-methods approach to understanding awareness and experience. Cancer. 2005; 104( 12 suppl): 3015–3024.Direct Link:
- 66,,,. Physician perspectives on increasing minorities in cancer clinical trials: an Eastern Cooperative Oncology Group (ECOG) Initiative. Ann Epidemiol. 2000; 10( 8 suppl): S78–S84.
- 67
- 68. Clinical trial participation. Viewpoints from racial/ethnic groups. Cancer. 1994; 74( 9 suppl): 2687–2691.Direct Link:
- 69,,. Attitude of African-Americans regarding prostate cancer clinical trials. J Commun Health. 1996; 21: 77–87.
- 70,,, et al. Recruitment and retention challenges in breast cancer survivorship research: results from a multisite, randomized intervention trial in women with early stage breast cancer. Cancer Epidemiol Biomarkers Prev. 2003; 12: 1087–1090.
- 71,,, et al. Factors associated with breast cancer clinical trials participation and enrollment at a large academic medical center. J Clin Oncol. 2004; 22: 2046–2052.
- 72
- 73,,,,. Identifying, recruiting, and enrolling adolescent survivors of childhood cancer into a randomized controlled trial of health promotion: preliminary experiences in the Survivor Health and Resilience Education (SHARE) Program. J Pediatr Psychol. 2006; 31: 252–261.
- 74,,. Participation and adherence among older men and women recruited to the Beta-Carotene and Retinol Efficacy Trial (CARET). Gerontologist. 1991; 31: 593–597.
- 75,,,,,. Factors affecting older African American women's decisions to join the PLCO Cancer Screening Trial. J Clin Oncol. 2005; 23: 8730–8738.
- 76,,,. Entry into clinical trials in breast cancer: the importance of specialist teams. Scottish Breast Cancer Focus Group and Scottish Cancer Therapy Network. Eur J Cancer. 1998; 34: 1004–1007.
- 77,,,,,. Participation of African Americans in a smoking cessation trial: a quantitative and qualitative study. J Natl Med Assoc. 2002; 94: 609–618.
- 78,,, et al. Provider roles in the recruitment of underrepresented populations to cancer clinical trials. Cancer. 2007; 109: 465–476.Direct Link:
- 79,. The challenge of minority recruitment in clinical trials for AIDS. JAMA. 1992; 267: 954–957.
- 80,,, et al. Organizational barriers to physician participation in cancer clinical trials. Am J Manag Care. 2005; 11: 413–421.
- 81. The impact of clinical trial protocols on patient care systems in a large city hospital. Access for the socially disadvantaged. Cancer. 1993; 72( 9 suppl): 2834–2838.Direct Link:
- 82
- 83,,,,,. Statewide Tuskegee Alliance for Clinical Trials. A community coalition to enhance minority participation in medical research. Cancer. 2001; 91( 1 suppl): 237–241.Direct Link:
- 84,,. Participation of Asian-American women in cancer chemoprevention research: physician perspectives. Cancer. 2005; 104( 12 suppl): 3006–3014.Direct Link:
- 85,,,. Perceptions of African-American culture and implications for clinical trial design. Ethnic Dis. 2005; 15: 292–299.
- 86,,,. Attitudes and beliefs of African Americans toward participation in medical research. J Gen Intern Med. 1999; 14: 537–546.Direct Link:
- 87,,, et al. Effectiveness of strategies to recruit underrepresented populations into cancer clinical trials. Clin Trials. 2006; 3: 133–141.
- 88,,, et al. Special populations recruitment for the Women's Health Initiative: successes and limitations. Control Clin Trials. 2004; 25: 335–352.

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