A Tri-Institutional Approach to Address Disparities in Children's Oncology Group Clinical Trial Accrual for Adolescents and Young Adults and Underrepresented Minorities
Autor: | Paul Kent, Nupur Mittal, Cathleen Kiely, Steven Gitelis, Kathleen Breen, John G. Quigley, Asneha Iqbal, Mario F Martinez, Rosalind Catchatourian, Nitin Sane, Lisa Giordano, Jonathan Davidson, Reynaldo Sanchez, Mary Lou Schmidt, Dipti Dighe, Daniel K. Choi |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Oncology medicine.medical_specialty Adolescent Specialty Ethnic group Medically Underserved Area Medical Oncology Health Services Accessibility Young Adult 03 medical and health sciences 0302 clinical medicine Cog Underrepresented Minority Internal medicine medicine Humans 030212 general & internal medicine Healthcare Disparities Retrospective Studies business.industry Age Factors Institutional review board Underinsured Health equity Clinical trial 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Female business |
Zdroj: | Journal of Adolescent and Young Adult Oncology. 8:227-235 |
ISSN: | 2156-535X 2156-5333 |
Popis: | Purpose: Enrollment in Children's Oncology Group (COG) clinical trials has led to significant improvements in survival; however, disparities in survival persist, particularly among ethnic minorities, adolescents and young adults (AYAs), and the underinsured, partly due to inadequate access to cooperative group cancer clinical trials. In 2008, two COG sites University of Illinois at Chicago (UIC) and Rush University Medical Center, and a nonmember institution, John H Stroger Hospital, created a unified COG program utilizing one lead Institutional Review Board and research team. This study assesses the impact that the tri-institutional COG program had on clinical trial accrual for minority, AYA, and uninsured patients. Methods: Analysis and comparison of COG enrollment data from 2002 to 2008 (pre-merger) and 2008 to 2017 (post-merger) by age, ethnicity, insurance type, clinical trial type, oncologic diagnosis, and specialty of the enrolling physician were completed. Results: Following the merger, the total studies open to enrollment increased by 100%, enrollments increased by 446%, and, for each diagnoses, increased by more than 200%. Enrollment of ethnic minorities rose by 533%, most significantly for Hispanic patients by 925%. AYA enrollments increased by 822%. There was a 28-fold increase in enrollment of uninsured patients. Significantly more providers from various oncology specialties were engaged in enrolling patients and a consistent increase in the percentile standing of the program occurred after the merger. Conclusions: Creation of a tri-institutional COG research program was associated with significant increases in clinical trial enrollments, especially for underrepresented minorities, AYAs, and uninsured patients. The UIC/Rush/Stroger COG Program provides a novel and exemplary approach to address cancer health disparities for these vulnerable populations. |
Databáze: | OpenAIRE |
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