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Recruiting Minority Cancer Patients Into Cancer Clinical Trials: A Pilot Project Involving the Eastern Cooperative Oncology Group and the National Medical Association

From the Division of Cancer Prevention, National Cancer Institute/National Institutes of Health, Rockville, MD; Oncology Division, Stanford Medical Center, Stanford, CA; AMC Cancer Research Center, Denver, CO; Eastern Cooperative Oncology Group, Philadelphia, PA; National Medical Association, Merrillville, IN; and University of Colorado, Health Science Center, Denver, CO.

Address reprint requests to Worta McCaskill-Stevens, MD, Division of Cancer Prevention, National Cancer Institute/National Institutes of Health, 6130 Executive Blvd, Room 300, Rockville, MD 20852; email wm57h{at}nih.gov

PURPOSE: Minority accrual onto clinical trials is of significant interest to cooperative oncology study groups. The Eastern Cooperative Oncology Group (ECOG) conducted a study to identify barriers and solutions to African American accrual onto clinical trials.

METHODS: We hypothesize that the National Medical Association (NMA) might provide insight into ways to increase minority participation and that ECOG might facilitate that participation. Four sites were selected in which NMA chapters existed and ECOG main institutions with less than half of the corresponding percentage of minorities in their communities entered trials for 1992. Fifteen workshops were conducted using discussions and open-ended, self-administered questionnaires.

RESULTS: Seventy percent of NMA physicians cited mistrust of the research centers, fear of losing patients, and a lack of respect from ECOG institutions as the most important barriers to minority cancer patient referrals, compared with 30% for ECOG physicians. Sixty-nine percent of NMA and 43% of ECOG physicians cited a lack of information about specific trials. Nearly half of NMA physicians (47%) cited a lack of minority investigators as a barrier, compared with 4% of ECOG physicians. Solutions by both groups were improved communication (73%) and culturally relevant educational materials (40%). ECOG physicians cited more minority outreach staff as a potential solution (22% v 6%). NMA physicians cited increased involvement of referring physicians (44% v 4%).

CONCLUSION: NMA physicians who serve a significant sector of the African American population demonstrated a willingness to participate and work with a cooperative group effort to increase participation of minority patients and investigators.

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