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Am J Clin Oncol. 2018 Jun;41(6):581-587. doi: 10.1097/COC.0000000000000327.

Knowledge of Clinical Trial Availability and Reasons for Nonparticipation Among Adolescent and Young Adult Cancer Patients: A Population-based Study.

Author information

1
Department of Urology, Division of Pediatric Urology, University of Washington, Seattle Children's Hospital.
2
Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA.
3
Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA.
4
Keck School of Medicine, University of Southern California, Los Angeles.
5
Departments of Oncology and Pathology, School of Medicine, Wayne State University, Detroit, MI.
6
Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA.
7
Department of Epidemiology, University of Iowa, Iowa City, IA.
8
Department of Internal Medicine, Division of Hematology and Oncology, School of Medicine, University of California, Davis, Sacramento, CA.
9
Applied Research Program, National Cancer Institute, Bethesda, MD.
10
Department of Epidemiology, University of Washington.

Abstract

PURPOSE OF THE STUDY:

Adolescent and young adult (AYA) cancer patients are underrepresented in clinical trials, but the reasons for this phenomenon are unknown.

PATIENTS AND METHODS:

Questionnaire and medical record data from 515 AYA cancer patients (21 acute lymphocytic leukemia [ALL], 201 germ cell tumor, 141 Hodgkin lymphoma, 128 non-Hodgkin lymphoma, 24 sarcoma) from a population-based study were analyzed. We used multivariable models to determine characteristics associated with patient knowledge of the availability of clinical trials for their cancer. Reasons for not participating in a trial were tabulated.

RESULTS:

In total, 63% of patients reported not knowing whether a relevant clinical trial was available, 20% reported knowing that a clinical trial was not available, and 17% reported that a trial was available. Among patients reporting an available trial, 67% were recommended for enrollment. Knowing about the availability of clinical trials was associated with having ALL (odds ratio=2.9, 95% confidence interval=1.1, 7.8). Reporting that a clinical trial was available was positively associated with having ALL, Hodgkin lymphoma, non-Hodgkin lymphoma and sarcoma (relative to germ cell tumor) and working full-time or in school full-time (odds ratio=2.6, 95% confidence interval=1.0, 6.7). Concerns about involvement in research (57%) and problems accessing trials (21%) were the primary reasons cited for not enrolling among patients who knew that a trial was available.

CONCLUSIONS:

Improvement in AYA cancer patient clinical trial enrollment will require enhancing knowledge about trial availability and addressing this population's concerns about participating in medical research.

PMID:
27635619
DOI:
10.1097/COC.0000000000000327
[Indexed for MEDLINE]

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