New Research Finds Huge Ethnic, Age, And Gender Gap In Clinical Cancer Trials

New research published in the Journal of Clinical Oncology has found a significant discrepancy in clinical trials of cancer treatments. The study, led by Dr. Narjust Duma, a hematologist and oncologist at the Mayo Clinic in Rochester, Minnesota, found that four out of five of participants in clinical trials for cancer treatments are white.

The study also found that not only are other ethnicities missing from these trials, but women and elderly patients are missing as well. The authors of the study say that these results call the quality of cancer treatments many patients are receiving into question.

According to Dr. Duma, previous studies have proven that a cancer treatment’s effectiveness varies depending on a patient’s age, gender, and race. Yet the leaders of the clinical studies have chosen to test new therapies and medications only on a select number of people with little inclusivity.

“All the data we’re using to guide cancer treatment is for one type of patient,” said Dr. Duma.

The study analyzed U.S. cancer therapy trials over the course of 13 years between 2003 and 2016. Out of 55,000 clinical trial participants, 83% of participants were white, 6% were black, 5% were Asian, 3% were Hispanic, and 2% were listed Other.

In addition to these low percentages of ethnicities, only 36% of patients who were involved in the clinical trials were over 65. Age can have a significant effect on cancer patients. Even something as simple as the common cold, whose symptoms can last anywhere between 48 hours to 14 days, has a more significant impact on seniors. A patient’s risk of cancer increases as they age and their ability to respond to certain treatments also changes.

The study also found that in clinical studies of melanoma treatments, women made up only 35% of participants. In trials for lung cancer, women made up only 39%. And finally, in trials for pancreatic cancer, women made up only 40% of the participants.

“Not including these folks in clinical trials means that doctors are not fully equipped to treat all the various types of cancer that can strike different groups,” said Dr. Christopher Li, a research professor of epidemiology at the Fred Hutchinson Cancer Research Center. “If these populations are underrepresented in clinical trials, there will also be an under-representation of the types of cancer that we know disproportionately affect them.”

Dr. Duma says research has been found in the past that has proven the differences in cancer treatments’ effectiveness.

For instance, higher percentages of estrogen in the body affect a tumor’s response to cancer drugs. Black patients may require larger doses of chemotherapy drugs because they appear to metabolize the treatment more quickly than others. And finally, elderly patients show evidence of suffering more harmful side effects from cancer treatment.

Common side effects of chemotherapy in the elderly include stomach and digestive problems, low blood counts, and damage to the nervous system. The latter side effect can have detrimental consequences as two of the most common causes of falls in seniors are dizziness and unsteadiness.

Duma suggests medical journals could help to promote inclusivity in clinical trials by refusing to publish research failing to vary their participants. If a group in the study is underrepresented, the researchers should provide reasoning as to why.

Inclusive clinical trials may not only improve the health of Americans across a multitude of ethnic and gender spectrums but may also help to support elderly patients. Elderly patients are more likely to use home health care businesses, which are recommended to carry or at least know of up to five types of insurance. With age-inclusive clinical trials, these home health care workers may be able to better assist those living on fixed incomes with a higher number of medications.

“Recognizing the problem is the first step,” said Dr. Duma. “You cannot fix a problem before you come to realize it’s a real issue.”