Wood Charles G, Wei S Jack, Hampshire Margaret K, Devine Pamela A, Metz James M
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Am J Clin Oncol. 2006 Dec;29(6):593-9. doi: 10.1097/01.coc.0000236213.61427.84.
Enrollment of adult cancer patients in clinical trials remains low, particularly in the minority population. Understanding patient attitudes towards clinical trials during the recruitment process may enhance accrual. Unfortunately, data describing patient attitudes towards clinical trials are limited, particularly in the radiation oncology clinic setting.
A piloted questionnaire assessing basic demographics and attitudes toward clinical trials was offered in 2 radiation oncology clinics between April 2003 and October 2003. The questionnaire was completed by 166 patients. The mean age of the patients completing the questionnaire was 56 years (range, 15-84 years). Of the 166 patients included in the analysis, 108 (65%) were White. The most common cancer diagnoses included prostate (19%), head and neck (16%), and breast (14%).
There was no statistical difference between Whites and non-Whites regarding their interest in learning about clinical trials (84.3% versus 84.9%, P = 0.92); nor was there a significant difference in the rate of previous or current trial enrollment (21.3% versus 34.0%, P = 0.08). White patients were more likely to gather information about clinical trials from the Internet (30.6% versus 11.3%, P = 0.007), and they were more likely to use physicians as a source of this information (50.0% versus 34.0%, P = 0.05). Non-White patients were more likely to obtain information about clinical trials from other patients (24.5% versus 12.0%, P = 0.04). In addition, more non-White patients believed they had been treated on clinical trials without their knowledge (21.6% versus 9.3%, P = 0.032). Patients differed somewhat in their expectations of clinical trials. More non-Whites indicated that they would need a >50% chance of benefiting from a trial (64.4% versus 45.0%, P = 0.03) to enroll on that trial, though there were no statistical differences in outlook towards potential toxicities associated with treatment on a clinical trial.
Minority patients historically enroll in clinical trials at a significantly lower rate. Our study of radiation oncology patients documents significant differences in attitudes towards clinical trials between Whites and non-Whites. Understanding the differences in attitudes may allow physicians to overcome barriers that would otherwise hinder the enrollment of non-White patients into clinical trials.
成年癌症患者参与临床试验的比例仍然很低，尤其是在少数族裔人群中。了解患者在招募过程中对临床试验的态度可能会提高入组率。不幸的是，描述患者对临床试验态度的数据有限，尤其是在放射肿瘤学门诊环境中。
2003年4月至2003年10月期间，在2家放射肿瘤学诊所提供了一份试点问卷，评估基本人口统计学特征和对临床试验的态度。166名患者完成了问卷。完成问卷的患者的平均年龄为56岁（范围为15 - 84岁）。在纳入分析的166名患者中，108名（65%）为白人。最常见的癌症诊断包括前列腺癌（19%）、头颈癌（16%）和乳腺癌（14%）。
白人患者和非白人患者在了解临床试验的兴趣方面没有统计学差异（84.3%对84.9%，P = 0.92）；既往或当前参与试验的比例也没有显著差异（21.3%对34.0%，P = 0.08）。白人患者更有可能从互联网上收集有关临床试验的信息（30.6%对11.3%，P = 0.007），并且他们更有可能将医生作为获取该信息的来源（50.0%对34.0%，P = 0.05）。非白人患者更有可能从其他患者那里获取有关临床试验的信息（24.5%对12.0%，P = 0.04）。此外，更多非白人患者认为他们在不知情的情况下接受了临床试验治疗（21.6%对9.3%，P = 0.032）。患者对临床试验的期望存在一定差异。更多非白人表示，他们需要有超过50%的机会从试验中获益（64.4%对45.0%，P = 0.03）才会参加该试验，不过在对与临床试验治疗相关的潜在毒性的看法上没有统计学差异。
历史上少数族裔患者参与临床试验的比例显著较低。我们对放射肿瘤学患者的研究记录了白人和非白人在对临床试验态度上的显著差异。了解这些态度差异可能使医生能够克服那些否则会阻碍非白人患者参与临床试验的障碍。
