Abstract A007: Disparities in cancer clinical trial participation: The influences of race and social support among cancer survivors
Authors: Cooper Dexter L. , Rivers Desiree , Hernandez Natalie D. , Harris Monica , Caplan Lee , McKinney Lawrence , Rivers Brian M. 
Published: August 2020

Background: Cancer clinical trials (CCTs) are essential to developing effective cancer treatments; however, there is a disparity in the number of Black CCT participants. Studies have found that Black cancer survivors' responses to some cancer treatments are less than ideal compared to their White counterparts. With less than 3% of eligible Blacks participating in CCTs nationwide, it is difficult to evaluate the effectiveness of cancer treatments for this group. Social support (SS), among other factors, influence survivors' decisions about participating in CCTs. Though survivors make the final decision to participate in a CCT, the input from family and friends is valuable to their decision-making process. The purpose of this study is to examine 1) survivors' awareness about CCTs via discussion with a provider; 2) CCT participation by race; and 3) the effect of SS in discussion about CCTs with a provider on CCT participation.

Methods: This study used constructs based on the Social Ecological Model at the individual, interpersonal, and organizational levels. We merged cohort data from the Health Information National Trends Survey for years 2012, 2014, and 2016. The study included 1,340 cancer survivors who self-identified as White or Black and were at least 18 years of age. Chi-square and binomial logistic regression analyses examined the associations between SS and CCT discussion with a provider and CCT participation.

Results: The sample was mostly White (85.7%), female (59.0%), and married/living as married (62.5%), with a mean age of 65.83 (SD=14.751). Most of the sample had emotional support (87.5%) and instrumental support (tangible help) (77.9%). Only 9.3% of the sample discussed CCT as a treatment option, and 4% participated in a CCT. Bivariate analyses showed that survivors were more likely to have discussed CCT with their provider if they were retired (p=0.04), Black (p&lt;0.001), and received a treatment summary (p&lt; 0.001). Survivors were more likely to participate in a CCT if their employment status was disabled (p=0.012), they were Black (p=0.002), and they discussed CCT as a treatment option (p&lt; 0.001). Binomial logistic regression analyses showed that survivors who were most likely to have discussed CCT as a treatment option were Black (p=0.01), had instrumental support (p=0.05), and participated in a CCT (p&lt; 0.001) when controlling for sociodemographic and health-related variables. Survivors were more likely to have participated in a CCT if they were retired (p=.04) and discussed CCT as a treatment option (p&lt; 0.001).

Conclusion: Findings indicate that Black cancer survivors have discussions about CCTs with providers if returned, received a treatment summary, had instrumental support, were disabled and discussed CCT as a treatment option; however, they are not more likely to participate in CCTs. Further research to determine factors that affect the discussion about CCT, CCT participation, and the direction SS drives CCT participation among Black cancer survivors is warranted.

Citation Format: Dexter L. Cooper, Desiree Rivers, Natalie D. Hernandez, Monica Harris, Lee Caplan, Lawrence McKinney, Brian M. Rivers. Disparities in cancer clinical trial participation: The influences of race and social support among cancer survivors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A007.