Asian Americans and cancer clinical trials

Abstract

Cancer clinical trials have been based on low accrual rates. Barriers to recruitment of minority populations affect the generalizability and impact of trial findings for those populations. The authors undertook a mixed-methods approach to understanding levels of awareness and experiences with cancer clinical trials. A survey was administered to new cancer patients and their caretakers (family, close friends, or other social support) at outpatient oncology clinics. Field observations of the trial accrual process also were conducted by employing the grounded theory approach in qualitative methods. Comparison of survey results for Asian-American respondents and non-Asian respondents indicated that Asians were less likely to have heard the term "clinical trial" and were more likely to define a clinical trial as "an experiment" or "a test procedure in a clinic" than non-Asians. Asians were more likely to have employer-based insurance and to report understanding issues related to cost reimbursement. Asians were less likely to have been involved in or to know someone in a trial and reported less willingness than white respondents to consider trial participation. Qualitative observations suggested that Asians who presented for a potential trial were interested in the availability of a novel cancer therapy but were not eligible for available trials. Multiple strategies will be necessary to enhance awareness of and experience with accrual to cancer clinical trials for Asians, including richer understanding and increased involvement of Asians in cancer clinical trials and greater attention to the location and diversity of the Asian population in structuring study centers and evaluating trial results.

Incorporating cultural values and use of technology platforms may help outreach Asian Americans in cancer clinical trial participation

“…[1,7] Studies on Asian Americans have shown evidence of cultural differences in belief and attitude, [9,10] healthcare decision-making [11,12] and perception regarding clinical trial participation. [1,[13][14][15][16][17][18][19] Despite growing body of findings related to clinical trial participation, enrollment into clinical trials from Asian Americans remains low. [8] This paper aims to describe findings from a pilot study on barriers, promoters of and recommendations for cancer clinical trial participation among Chinese, Filipino and Hmong Americans.…”

Testing Targeted Approaches to Enhance Cancer Genetics Network Minority Recruitment within Asian Populations

“…Barriers to recruitment of minority populations can affect the generalizability and impact of research findings for those populations [2, 3]. Although Asian Americans represent one of the major minority groups in the US, there is a paucity of published literature concerning the participation of Asian Americans in cancer research [3,4,5,6].…”

“…Although Asian Americans represent one of the major minority groups in the US, there is a paucity of published literature concerning the participation of Asian Americans in cancer research [3,4,5,6]. Many recruitment barriers exist among the Asian population [4,5,6,7,8,9], generally including a lack of knowledge related to cancer and genetics, as well as cultural beliefs which influence attitudes toward cancer.…”

Participation in Cancer Clinical Trials as Viewed by Chinese Patients and Their Families

“…Although one study [1] showed that demographic factors do not influence patients’ willingness to participate, numerous other studies [6,7,8,9,10,11,12] revealed that patients’ attitudes toward clinical trials are related to their age, gender, stage of disease, education, religiousness and socioeconomic status. In addition, the race of patients is an important factor affecting their willingness to participate [7,10,11,13,14,15]. So it is important to investigate the attitude of cancer patients with different cultural backgrounds.…”

“…An important factor in carrying out successful clinical trials is the attitude of cancer patients towards such trials. A number of studies [1,2,3,4,5,6,7,8,9,10,11,12,13] have examined the attitude of patients toward enrolling in a cancer clinical trial. Although one study [1] showed that demographic factors do not influence patients’ willingness to participate, numerous other studies [6,7,8,9,10,11,12] revealed that patients’ attitudes toward clinical trials are related to their age, gender, stage of disease, education, religiousness and socioeconomic status.…”