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乳腺癌临床试验中种族和民族报告不足。

Insufficient Reporting of Race and Ethnicity in Breast Cancer Clinical Trials.

机构信息

Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.

True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA.

出版信息

Ann Surg Oncol. 2023 Nov;30(12):7008-7014. doi: 10.1245/s10434-023-14201-z. Epub 2023 Sep 1.

Abstract

BACKGROUND

Reporting race and ethnicity in clinical trial publications is critical for determining the generalizability and effectiveness of new treatments. This is particularly important for breast cancer, in which Black women have been shown to have between 40 and 100% higher mortality rate yet are underrepresented in trials. Our objective was to describe changes over time in the reporting of race/ethnicity in breast trial publications.

PATIENTS AND METHODS

We searched ClinicalTrials.gov to identify the primary publication linked to trials with results posted from May 2010-2022. Statistical analysis included summed frequencies and a linear regression model of the proportion of articles reporting race/ethnicity and the proportion of non-White enrollees over time.

RESULTS

A proportion of 72 of the 98 (73.4%) studies that met inclusion criteria reported race/ethnicity. In a linear regression model of the proportion of studies reporting race/ethnicity as a function of time, there was no statistically significant change, although we detected a signal toward a decreasing trend (coefficient for quarter = -2.2, p = 0.2). Among all studies reporting race and ethnicity over the study period, the overall percentage of non-White enrollees during the study period was 21.9%, [standard error (s.e.) 1.8, 95% confidence interval (CI) 18.4, 25.5] with a signal towards a decreasing trend in Non-White enrollment [coefficient for year-quarter = -0.8 (p = 0.2)].

CONCLUSION

Our data demonstrate that both race reporting and overall representation of minority groups in breast cancer clinical trials did not improve over the last 12 years and may have, in fact, decreased. Increased reporting of race and ethnicity data forces the medical community to confront disparities in access to clinical trials. This may improve efforts to recruit and retain members of minority groups in clinical trials, and over time, reduce racial disparities in oncologic outcomes.

摘要

背景

在临床试验出版物中报告种族和民族对于确定新治疗方法的普遍性和有效性至关重要。对于乳腺癌而言,这一点尤为重要,因为黑人女性的死亡率比白人高出 40%至 100%,但她们在试验中的代表性不足。我们的目的是描述在乳腺癌试验出版物中报告种族/民族情况随时间的变化。

患者和方法

我们在 ClinicalTrials.gov 上搜索了从 2010 年 5 月至 2022 年公布结果的试验的主要出版物。统计分析包括汇总频率以及随时间报告种族/民族的文章比例和非白人入组者比例的线性回归模型。

结果

符合纳入标准的 98 项研究中有 72 项(73.4%)报告了种族/民族。在报告种族/民族的研究比例随时间变化的线性回归模型中,没有统计学意义上的变化,但我们发现趋势呈下降趋势(季度系数=-2.2,p=0.2)。在整个研究期间报告种族和民族的所有研究中,研究期间非白人入组者的总体百分比为 21.9%(标准误差(s.e.)1.8,95%置信区间(CI)18.4,25.5),非白人入组的趋势呈下降趋势[年度季度系数=-0.8(p=0.2)]。

结论

我们的数据表明,在过去 12 年中,乳腺癌临床试验中种族报告和少数族裔总体代表性都没有改善,实际上可能有所下降。增加种族和民族数据的报告迫使医学界正视临床试验中获得机会的差异。这可能会改善招募和留住少数族裔成员参与临床试验的努力,并随着时间的推移,减少肿瘤学结果中的种族差异。

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