Abstract 5048: Racial/ethnic diversity in pediatric oncology clinical trial enrollment at Rady Children's Hospital San Diego
Authors: Aristizabal Paula , Singer Jenelle , Cooper Renee , Milburn Mehrzad , Schiff Deborah , Martinez M. Elena 
Published: May 2015

Background: In the United States, more than 12,000 children ages 0-21 are diagnosed with cancer each year. Over the past few decades, survival rates in pediatric oncology have improved dramatically, as a result of the successful enrollment of approximately 70% of the cases in clinical trials. However, cancer is still the leading cause of death by disease in children, ages 1-14. Little work has been done to assess disparities in clinical trials enrollment in pediatric oncology.

Purpose: To assess disparities in clinical trial participation for childhood cancer by age, sex, cancer type, insurance, language, and Hispanic ethnicity at RCHSD.

Methods: Data including enrollment onto any clinical trial at RCHSD for newly diagnosed patients in 2008-2012 was collected. We sub-grouped and analyzed by race/ethnicity, age, sex, cancer type (solid or liquid), insurance, and language. Protocols were divided into 3 groups: Biology, Treatment and Registry. Basic descriptive statistics were calculated using SPSS statistical software. Significant differences were tested using a chi-square analysis and 95% confidence intervals. (Significance = p &lt; 0.05).Rates of enrollment among different sub-groups were obtained and compared.

Results: There were 594 cases included in the analysis. The overall rate of enrollment for all race/ethnicities on any protocol was 59.3%. When analyzing by race/ethnicity, only comparisons between Hispanics and Non-Hispanic whites (NHWs) were assessed. Our analysis revealed significant underrepresentation among Hispanics (55.3 %) when compared to NHWs (65.0 %) enrolled in any protocol (p=0.044) and in enrollment onto Biology protocols (77.0% vs. 86.6%) (p=0.036), among males (54.5%) when compared to females (65.7%) enrolled in any protocol (p=0.008), enrollment onto solid cancer (53.8%) compared to liquid cancer (65.4%) (p=0.006), and among 15-21 year olds (47.2%) when compared to all other age groups in any protocol (p&lt;0.001). No disparities were found among different languages or insurance coverage.

Conclusion: Significant underrepresentation in clinical trial participation was observed for Hispanics, 15-21 year olds, males, and those with a solid cancer type. Equality in clinical accrual across underrepresented groups, including minorities is crucial to ensuring equivalent treatment and survival outcomes for all pediatric cancer patients. More research is needed to better understand barriers to participation from the patient, family, and physician's perspectives and to formulate targeted interventions.

Citation Format: Paula Aristizabal, Jenelle Singer, Renee Cooper, Mehrzad Milburn, Deborah Schiff, M. Elena Martinez. Racial/ethnic diversity in pediatric oncology clinical trial enrollment at Rady Children's Hospital San Diego. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5048. doi:10.1158/1538-7445.AM2014-5048