Bridging the Racial Gap: Underrepresentation of Minorities in Prostate Clinical Trials
Posted: Thursday, June 25, 2020
There may be many reasons to exclude a given candidate from enrolling in a clinical trial, but race should not be one of them. Although blacks and Latino individuals are at high risk for prostate cancer, Lorelei A. Mucci, MPH, ScD, of Harvard T.H. Chan School of Public Health, Boston (Harvard Chan), and colleagues reported that the majority of prostate cancer clinical trials are disproportionately white. Their findings were published in Cancer Epidemiology, Biomarkers & Prevention.
“In the United States, less than 60% of prostate cancer cases occur in non-Hispanic white men, and roughly 22% of cases occur in non-Hispanic black men,” commented coauthor Emily M. Rencsok, an MD/PhD student also at Harvard Chan in an American Association for Cancer Research press release. “However, when we analyzed the diversity of enrollment in nearly 60 prostate cancer clinical trials, we found that over 96% of participants were white.”
The researchers reviewed 72 global phase II and IV prostate cancer treatment, prevention-, and screening-based clinical trials that enrolled participants between 1987 and 2016. Of the 72 clinical trials analyzed, 59 had data on race available (81.9%). In addition, only 11 of the 59 clinical trial reported ethnicity information. Six trials did not collect or share race/ethnicity data (8.3%). In trials reporting race, white was always reported, and black or African American was reported 85% of the time.
White men comprised 96% of the total enrollment across all prostate cancer trials. Conversely, the proportion of minority enrollment differed by the type of study. Black or African American men made up 0.5% of participants in screening trials and 8.5% in prevention trials. Enrollment of black or African American men were also highest between 1995 and 1999 at 11.3%, but this substantially decreased to 2.8% between 1995 and 2014. Geographically, North American and European countries tended to be well represented in clinical trials, whereas some Caribbean and African countries were not represented at all.
Disclosure: For full disclosures of the study authors, visit cebp.aacrjournals.org.