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Researchers have found that cancer patients with household incomes lower than $50,000 were less likely to participate in clinical trials than patients whose annual incomes were higher than that amount. They also were more concerned about how to pay for clinical trial participation.

The study was a collaboration between the Southwest Oncology Group (SWOG) and NexCura which, before its sale, ran an online treatment decision tool made available to patients by cancer advocacy organizations. Joseph Unger, PhC, of the SWOG Statistical Center and the Fred Hutchinson Cancer Research Center in Seattle, Washington, and colleagues surveyed 5499 patients who registered with the decision tool. The findings, presented at the American Society of Clinical Oncology annual meeting in June, demonstrated that 7.6% of survey takers with an annual income below $50,000 reported participating in clinical trials, whereas 10% of those with incomes of $50,000 or more said they participated.

Unequal Access

The results were concerning, Dr. Unger says, because they indicate that lower income patients may not have equal access to trials that offer state-of-the-art therapy. In addition, researchers could be better assured that clinical trial results applied to patients across the income spectrum if more lower income patients participated. Finally, if more patients participated in clinical trials, they could be completed more quickly, leading to the faster development of new treatments.

Lower income patients also were more likely to be concerned about how to pay for their care if they were part of a clinical trial. These patients may be more affected by the indirect costs of clinical trials, including getting time off of work for clinic visits, Dr. Unger says.

Although lower income patients are more likely to suffer from a range of medical problems that could limit their eligibility for trials, the study was able to control for differences in health status. Nevertheless, the difference in participation rates by income level persisted.