Selection and Prejudice: Addressing Clinical Trial Disparities With a Review of Current Shortcomings and Future Directions

Authors

Kelsey L Corrigan
Michael K Rooney
Ramez Kouzy
Gohar Manzar
Charles R Thomas
Ethan B Ludmir

Publication Date

10-1-2023

Journal

Seminars in Radiation Oncology

Abstract

Growing evidence has demonstrated significant, persistent, and widespread disparities in cancer clinical trial enrollment across myriad disease sites and target populations. Although mechanisms underlying such disparities are complex and multifactorial, clinical trial eligibility criteria may serve as a key structural barrier to equitable and diverse trial enrollment. In this review, we provide an overview of the data describing historical and current disparities in cancer clinical trial enrollment and subsequently describe several patient-, institution-, and trial-related factors which appear to be key drivers of enrollment inequity, with specific discussion regarding the impact of eligibility criteria. We further describe the landscape of ongoing professional efforts aimed at eliminating clinical trial disparities through various medical, professional, and advocacy groups. The review concludes with a practical discussion of how modernization of eligibility criteria in clinical trials may decrease or eliminate trial disparities, including specific actionable recommendations aimed at improving the quality of future eligibility criteria.

Keywords

Humans, Prejudice, Clinical Trials as Topic

DOI

10.1016/j.semradonc.2023.06.002

PMID

37684066

PMCID

PMC11835201

PubMedCentral® Posted Date

2-18-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes