Moorman Patricia G, Skinner Celette Sugg, Evans James P, Newman Beth, Sorenson James R, Calingaert Brian, Susswein Lisa, Crankshaw T Sydnee, Hoyo Cathrine, Schildkraut Joellen M
Cancer Prevention Detection and Control Research Program, Duke University Medical Center, 239 Hanes House, Trent Drive, Box 2949, Durham, NC 27710, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Aug;13(8):1349-54.
Lower enrolment of minorities into research studies has been reported frequently. Most studies have little information about nonparticipants, making it difficult to identify characteristics associated with enrolment and how they might vary by race.
Women who had previously participated in a population-based, case-control study of breast cancer in North Carolina were invited to enroll in a cancer genetics registry. Detailed questionnaire data on sociodemographic characteristics and cancer risk factors were available for all women. We compared characteristics of women who agreed to be in the registry with those who were deceased, were unlocatable, or declined enrolment. Unconditional logistic regression analyses were done to identify predictors of enrolment.
Enrolment rates were markedly lower among African Americans than Whites (15% and 36%, respectively) due to both lower contact rates (41% versus 63%) and lower enrolment rates among those contacted (37% versus 58%). Logistic regression models suggested that racial differences in enrolment were not due to socioeconomic characteristics or other cancer risk factors; race was the only significant predictor of enrolment in multivariable models (odds ratio 0.41, 95% confidence interval 0.23-0.72).
Although all women had previously taken part in a research study, African American women were less likely to enroll in the cancer genetics registry than White women. A possible explanation of these findings is that studies of genetics may present particular concerns for African Americans. Further research is needed to identify attitudes and issues that present barriers to participation among minorities.
少数族裔参与研究的人数较低这一情况屡有报道。大多数研究关于未参与者的信息很少,因此难以确定与参与研究相关的特征以及这些特征如何因种族而异。
邀请曾参与北卡罗来纳州一项基于人群的乳腺癌病例对照研究的女性加入癌症遗传学登记处。所有女性都有关于社会人口学特征和癌症风险因素的详细问卷数据。我们比较了同意加入登记处的女性与已去世、无法找到或拒绝加入的女性的特征。进行无条件逻辑回归分析以确定参与研究的预测因素。
非裔美国女性的参与率明显低于白人女性(分别为15%和36%),这是由于接触率较低(41%对63%)以及被接触者中的参与率较低(37%对58%)。逻辑回归模型表明,参与率的种族差异并非由于社会经济特征或其他癌症风险因素;在多变量模型中,种族是参与研究的唯一显著预测因素(优势比0.41,95%置信区间0.23 - 0.72)。
尽管所有女性此前都参与过一项研究,但非裔美国女性比白人女性更不太可能加入癌症遗传学登记处。这些发现的一个可能解释是,遗传学研究可能使非裔美国人有特别的担忧。需要进一步研究以确定阻碍少数族裔参与的态度和问题。