Background: Ethnic and socioeconomic disparities in cancer outcomes are exacerbated by clinical trial underrepresentation. This study aims to identify inequalities in ethnicity and socioeconomic features among ovarian cancer clinical trial participants in two London cancer centres. Methods: All ovarian cancer patients treated between 2017 and 2022 were included. Patients participating in clinical trials were classified as the trial population (TP); the remainder were considered the non-trial population (NTP). Data on disease characteristics and sociodemographic features, including ethnicity and Indices of Multiple Deprivation (IMD) deciles, were accessed from electronic patient records. Results: Of the 892 patients, 212 (24%) were enrolled in trials: 87 in Phase II, 103 in Phase III, and 21 in prospective, non-investigational medicinal product trials. The TP were more likely to be of White ethnicity (72.6% vs. 57.5%;p< 0.001), younger (mean age 58 vs. 60;p= 0.003), living in less deprived areas (most deprived tercile: 21.2% vs. 34.0%;p= 0.004), and English-speaking (95.8% vs. 90.9%;p= 0.041). In the multivariate analysis, White ethnicity (p< 0.0001), age (p= 0.003), IMD decile (p= 0.007), and interpreter requirement (p= 0.037) were independent predictors of trial participation. Conclusions: Ethnic and socioeconomic inequalities affect trial participation, potentially worsening health disparities in ovarian cancer patients. Strategies to overcome trial recruitment barriers for underserved groups are needed to improve the equity of care.
背景：临床试验参与度不足加剧了癌症预后中的种族和社会经济差异。本研究旨在分析伦敦两家癌症中心卵巢癌临床试验参与者在种族和社会经济特征方面的不平等现象。方法：纳入2017年至2022年间所有接受治疗的卵巢癌患者。参与临床试验的患者被归类为试验人群（TP），其余患者被视为非试验人群（NTP）。从电子病历中获取疾病特征和社会人口学数据，包括种族和多重剥夺指数（IMD）十分位数。结果：在892例患者中，212例（24%）参与了临床试验：其中87例参与II期试验，103例参与III期试验，21例参与前瞻性非研究性药品试验。试验人群更可能为白人（72.6% vs. 57.5%；p<0.001）、更年轻（平均年龄58岁 vs. 60岁；p=0.003）、居住于贫困程度较低地区（最贫困三分位：21.2% vs. 34.0%；p=0.004）且以英语为母语（95.8% vs. 90.9%；p=0.041）。多变量分析显示，白人种族（p<0.0001）、年龄（p=0.003）、IMD十分位数（p=0.007）和翻译需求（p=0.037）是临床试验参与的独立预测因素。结论：种族和社会经济不平等影响临床试验参与度，可能加剧卵巢癌患者的健康差异。需要制定策略克服服务不足群体的试验招募障碍，以提升医疗公平性。
肿瘤(癌症)患者之家