The Role of Diverse Populations in US Clinical Trials

Challenges in Diversity, Equity, and Inclusion in Research and Clinical Oncology

“…It is only with community outreach and education and work within the community that cancer centers can hope to impact on the barriers to clinical trial enrollment and inclusivity. Erosion of trust in the medical system due to historical victimization of groups or individuals in human experimentation has impacted on the willingness of racial and ethnic minorities to participate in clinical trials (19). Acknowledgments of historical mistakes is a step towards impacting on how clinical trials are conducted, and in some cases the acknowledgements may need to be personal.…”

“…But there are other obstacles and challenges in the enrollment of racial and ethnic minorities in clinical trials. Such obstacles include access to care, education and communication gaps (19). Many interventions that are part of clinical trials include standard of care such as approved drugs which if not covered by insurance (or if the individuals have no insurance coverage) can add to the barriers and challenges that must be overcome to improve the inclusion of minorities and underserved racial and ethnic groups (22,23).…”

Genetic Contributions to Prostate Cancer Disparities in Men of West African Descent

“…Nonetheless, historically, the PCa disparity gap has been attributed to the fact that AA men are less likely to be screened for PCa ( 24 ). However, many reasons have been proposed to explain why AA men receive less screening, including but not limited to: poor communication between physicians and minority patients, lack of access to health care, stigmatization/fear and deficiency of knowledge about screening ( 25 , 39 , 40 ). Although there is increasing awareness, many AA men remain uninformed of the current early detection methods available for PCa (e.g., PSA testing), which is accounted for in the aforementioned studies regarding lower education being correlated to increased advanced PCa.…”

“…AAs are less likely to be enrolled in clinical trials which limits opportunities to access cutting-edge treatment options ( 153 ). The barriers to clinical trial enrollment are many and include trust, access to healthcare, education, and communication gaps ( 39 ). Given the history of targeted medical victimization of AAs throughout U.S. history, it is easy to comprehend the widespread medical mistrust that continues to exist.…”

“…Tactics include increased funding to encourage health disparities research as well as financial incentives to cover the direct and indirect costs of trial participation for enrolled patients. In addition, concerned medical institutions are reducing travel concerns by expanding community sites to neighborhoods that are inclusive of individuals at high-risk of disease disparities ( 39 ).…”