NewsChanging the Face of Clinical Trials
Leslie Harris O'Hanlon
"Overall, only about 5 to 10 percent of cancer patients participate in clinical trials. And when it comes to African-American cancer patients, the figures are even lower: 2 to 4 percent. This low participation makes it difficult for researchers to get answers to critical questions: Why are African-Americans more likely to develop certain cancers than other racial and ethnic groups and have higher death rates for some types of the disease? Is it lifestyle? Genetics? Treatment response? Access to health care? No one yet knows. But researchers believe that increasing the number of African-Americans in cancer trials will help them find out. So that can happen, more efforts are under way to identify the reasons that so few African-American cancer patients join clinical trials and to implement programs that can put them on the clinical trials track.
Questions and Concerns
"Increasing African-American participation in clinical trials requires a focus on issues ranging from their potential questions and concerns about the studies to how and when doctors discuss clinical trials with their patients. One known problem is that many African-Americans have historical reasons to distrust the clinical trials system?a legacy of the infamous government-sponsored Tuskegee study in which several hundred poor African-American sharecroppers in Alabama were intentionally not treated for syphilis because researchers wanted to study how the disease naturally progresses."
"Nikita Robinson, a senior research coordinator at the M. D. Anderson Cancer Center in Houston, Texas, says that even though Tuskegee happened decades ago, it still comes up in her conversations with African-American patients, especially older ones, when she tries to recruit them for clinical trials. ?I tell them that ? those things don?t happen anymore,? she says. ?Research is controlled now. It?s governed by review boards. [Researchers] can?t just do whatever they want.?
"Lower participation isn?t only a result of patients choosing not to join or being ineligible. Studies have found that physicians do not discuss clinical trials with their African-American patients as often as they do with their white patients. ?Physicians might feel that some [African-American] patients will not be able to understand the consent process or have the ability to adhere to the protocol,? says Susan Eggly, a communications scientist at the Karmanos Cancer Institute at Wayne State University in Detroit who studies patient-physician communication. ?They also might presume that patients will be unwilling to participate.?