Trends in participant race and sex reporting in lung cancer phase III clinical trials

Abstract

BackgroundClinical trials are an essential part of advancing care for cancer patients. Historically, however, racial minorities and females have been underrepresented in these trials. Efforts like the National Institute of Health Revitalization Act attempted to mitigate these disparities, but despite these efforts, they continue to exist. These disparities can subsequently lead to minorities and females receiving suboptimal care.AimsThe purpose of our study was to understand the changing trends in reporting of participant race and sex as a demographic variable in phase III lung cancer clinical trials published over the last 35 years given these consequences of poor representation.Methods and resultsA total of 426 articles reporting the results of phase III lung cancer clinical trials published from 1984 to 2019 were identified in PubMed. From these articles, data on participant sex and race were collected from the demographic tables to construct the database for this study. This database was subsequently used to determine the rate of reporting of demographic factors like race and sex and the participation trends over the time of minority and female participation in lung cancer phase III clinical trials. The SciPy Stats package for Python was used to calculate descriptive statistics, 95% confidence intervals, two sample t‐test, one‐way analysis of variance test, and Pearson's correlation coefficients. The Matplotlib package for Python was used for figure generation. Only 137 (32.2%) of the 426 studies analyzed reported the race of participants. Among those studies, we found that the mean participation rate of White participants was significantly higher (82.65%; p < .001). We found a decrease in African American participants and an increase in Asian participants over time. When looking at sex, we found that although the rate of male participation (69.02%) was significantly higher than that of female participation (30.98%), female participation has improved with time at a rate of 0.65% per year.ConclusionWe found that the reporting and participation of minority races continue to lag that of other demographic factors like sex in phase III clinical trials in lung cancer. Based on our analysis, we note a decline in participation of African Americans in lung cancer phase III clinical trials despite the rising incidence of lung cancer.

Identifying Populations at Risk for Lung Cancer Mortality from the National Health and Nutrition Examination Survey (2001–2018) Using the 2021 USPSTF Screening Guidelines

“…Additionally, socioeconomic (SES) factors further contribute to lower rates of healthcare access, participation, and medical compliance amongst African American and other minority patient populations [ 32 ]. Those with a lower SES status are more likely to be diagnosed with advanced stage LC with a consequently poorer prognosis, and African American patients have consistently experienced relatively more advanced stage cancer diagnoses compared to their White counterparts [ 33 ].…”

Bridging racial and ethnic disparities in cancer research

“…Thus, the study substantiates the evidence that continues to highlight the disparities surrounding races in clinical trials. 9 In addition, to enhance cancer treatment outcomes, Pathak and colleagues and Bharmjeet and Das emphasize the importance of collaboration among researchers, healthcare providers, and policymakers. 7 , 8 …”