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Thomas Flaig, MD


Study Finds Disproportionate Racial and Ethnic Representation in Clinical Trials for Bladder Carcinoma

By: Joshua D. Madera, MS
Posted: Tuesday, April 5, 2022

The representation of racial and ethnic minority patients with bladder carcinoma continues to be reduced in clinical trials, according to a study published in the Journal of Clinical Oncology. Due to the increased incidence of bladder carcinoma in these patient populations, future clinical trials should strive to recruit a more representative racial and ethnic patient population, explained Mark W. Ball, MD, of the National Cancer Institute, Bethesda, Maryland, and colleagues.

“To better serve the plurality of patients, the medical community at every level of the clinical trials process must be proactive in safely and inclusively investigating the medical needs of underrepresented and underserved individuals,” commented the study investigators.

From 2000 to 2017, data on race and ethnicity from patients with genitourinary cancers were collected from 169 phase II and III interventional trials using the Surveillance, Epidemiology, and End Results database. Races included were White/Caucasian; Black/African American; Asian; American Indian; Alaska Native, Native Hawaiian, or Pacific Islander; multiracial; or unknown/did not report. Ethnicities included were Hispanic/Latino or non-Hispanic/Latino. Data were stratified based on 3-year increments to analyze temporal changes.

The study findings revealed that there was an overrepresentation of White patients and an underrepresentation of Black and Asian patients in bladder carcinoma trials. This representation was consistent across all the 3-year increments analyzed. Furthermore, analysis of ethnicity revealed an underrepresentation of Hispanic and Latino patients in bladder carcinoma trials. Moreover, a more diverse patient population was identified in government-funded trials as compared with trials funded by academic institutions and industry. More than 50% of the initial trials examined did not include any patient data on race or ethnicity.

Disclosure: For full disclosures of the study authors, visit

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