Income, property ownership and financial stability were the leading indicators of enrollment in clinical cancer studies, according to a new study of Northeast Ohio cancer patients published by Case Western Reserve University and University Hospitals.
Race and demographics were lesser predictors, the December 17 study found.
Clinical trials that include large, socioeconomically diverse populations have been shown to result in treatments that are safer and more effective across various races and ethnicities than studies that do not seek diversity.
One way to ensure patients participate in greater numbers is to remove financially-driven barriers such as lack of transportation or childcare, said study author Dr. Richard Hoehn of Case Western Reserve School of Medicine.
“We can ... get out of our ivory tower a bit and not make the patients come to us," Hoehn said. "We need to design clinical trials that accommodate people who live and work in a huge region like Northeast Ohio.”
But Yvonka Hall, executive director of the Northeast Ohio Black Health Coalition, said the study failed to properly account for racial bias, including the practice of discriminatory mortgage lending, or redlining.
“[Patients said], 'I can't afford to get here,'" she said. "Well, why? Could it be the fact that you don't have a living wage? Because you are in a redlined area? We know that redlining looks at economics. It looks at housing. All of these things that disproportionately impacted communities of color.”
Researchers analyzed the medical records of 12,000 University Hospital cancer patients to determine how a demographically representative population could be encouraged to participate in local cancer studies.
Researchers are planning to expand the study in 2026 beyond University Hospital's patients to include clinical data for cancer patients at the Cleveland Clinic, MetroHealth and in the state cancer registry system, the Ohio Cancer Incidence Surveillance System.
The expanded study will account for approximately 95% of cancer trials in Northeast Ohio, providing a more comprehensive assessment of patients' reasons for participating, researchers said.