According to a story from journals.lww.com, The Lazarex Cancer Foundation and the University of California San Francisco have announced plans to work together on a three year study that will focus on the development of strategies to address the lack of diversity in cancer clinical trials. People with low-income as well as several racial groups are often not appropriately represented in clinical trials for cancer and for other diseases in general, even though the effects of a treatment may differ for people of varied racial backgrounds.
Lack of Diversity Makes Medicine Less Effective
Most clinical trial participants are middle-class and white. The fact that this group is so over-represented does a great deal to undermine the scientific integrity of these studies and creates medicines that useful and safe only to a limited and exclusive demographic of patients. This results in the continued perpetuation of health disparities. The study will operate primarily on the institutional level with the goal of developing new strategies that can successfully increase enrollment from historically marginalized ethnic groups and low-income people. A big focus of the study will be the identification of financial barriers that prevent patients from being part of trials, such as costs of lodging and transportation.
Disparities in access to clinical trials (and medical care in general) are issues that have long been understood by the medical community. However, there is been very little in the way of systemic change to help alleviate the problem. Poor people, women, and people of non-white ancestry consistently have lower life expectancy and less access to medical treatment, and even when they do have access, doctors do not always treat them in the same way.
A Big Problem With No Simple Fix
Beyond the impacts of subconscious biases, factors such as eligibility criteria for trials can also undermine the ability to recruit a suitable diverse group of trial participants. There probably isn’t going to be a magical one-size-fits-all solution to the problem as the circumstances of each trial and study differ in substantial ways, but diversity of participants simply needs to be a higher priority for the sake of scientific integrity and fairness and should be a part of clinical trial recruitment criteria whenever possible.
Another solution that could be helpful is making the reimbursement of participation costs standard. This way financial barriers could be lifted. In addition, greater efforts should be made to ensure that low-income communities and people of historical marginalized racial groups are informed about the existence of a trial in the first place.
These are just some of many useful solutions that can help solve this issue. Hopefully the results of this study will help inform the conduct of clinical trials in the future.
