TY  - JOUR
AU  - Mudaranthakam, Dinesh Pal
AU  - Gajewski, Byron
AU  - Krebill, Hope
AU  - Coulter, James
AU  - Springer, Michelle
AU  - Calhoun, Elizabeth
AU  - Hughes, Dorothy
AU  - Mayo, Matthew
AU  - Doolittle, Gary
PY  - 2022
DA  - 2022/4/21
TI  - Barriers to Clinical Trial Participation: Comparative Study Between Rural and Urban Participants
JO  - JMIR Cancer
SP  - e33240
VL  - 8
IS  - 2
KW  - rural residents
KW  - clinical trials
KW  - screening
KW  - cancer
KW  - patients
KW  - lung cancer
KW  - health policy epidemiology
KW  - cancer patients
KW  - electronic screening logs
KW  - electronic screening
AB  - Background: The National Clinical Trials Network program conducts phase 2 or phase 3 treatment trials across all National Cancer Institute’s designated cancer centers. Participant accrual across these clinical trials is a critical factor in deciding their success. Cancer centers that cater to rural populations, such as The University of Kansas Cancer Center, have an additional responsibility to ensure rural residents have access and are well represented across these studies. Objective: There are scant data available regarding the factors that act as barriers to the accrual of rural residents in these clinical trials. This study aims to use electronic screening logs that were used to gather patient data at several participating sites in The Kansas University of Cancer Center’s Catchment area. Methods: Screening log data were used to assess what clinical trial participation barriers are faced by these patients. Additionally, the differences in clinical trial participation barriers were compared between rural and urban participating sites. Results: Analysis revealed that the hospital location rural urban category, defined as whether the hospital was in an urban or rural setting, had a medium effect on enrolment of patients in breast cancer and lung cancer trials (Cohen d=0.7). Additionally, the hospital location category had a medium effect on the proportion of recurrent lung cancer cases at the time of screening (d=0.6). Conclusions: In consideration of the financially hostile nature of cancer treatment as well as geographical and transportation barriers, clinical trials extended to rural communities are uniquely positioned to alleviate the burden of nonmedical costs in trial participation. However, these options can be far less feasible for patients in rural settings. Since the number of patients with cancer who are eligible for a clinical trial is already limited by the stringent eligibility criteria required of such a complex disease, improving accessibility for rural patients should be a greater focus in health policy. 
SN  - 2369-1999
UR  - https://cancer.jmir.org/2022/2/e33240
UR  - https://doi.org/10.2196/33240
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35451964
DO  - 10.2196/33240
ID  - info:doi/10.2196/33240
ER  -