From the Duluth Campus, University of Minnesota School of Medicine, Duluth, MN.
Department of Radiation Oncology, Stanford Medicine, Palo Alto, CA.
Cancer J. 2023;29(6):310-315. doi: 10.1097/PPO.0000000000000675.
Access to and participation in cancer clinical trials determine whether such data are applicable, feasible, and generalizable among populations. The lack of inclusion of low-income and marginalized populations limits generalizability of the critical data guiding novel therapeutics and interventions used globally. Such lack of cancer clinical trial equity is troubling, considering that the populations frequently excluded from these trials are those with disproportionately higher cancer morbidity and mortality rates. There is an urgency to increase representation of marginalized populations to ensure that effective treatments are developed and equitably applied. Efforts to ameliorate these clinical trial inclusion disparities are met with a slew of multifactorial and multilevel challenges. We aim to review these challenges at the patient, clinician, system, and policy levels. We also highlight and propose solutions to inform future efforts to achieve cancer health equity.
参与癌症临床试验的机会和参与情况决定了这些数据在人群中的适用性、可行性和可推广性。在纳入低收入和边缘化人群方面的不足限制了指导在全球使用的新型治疗方法和干预措施的关键数据的可推广性。考虑到经常被排除在这些试验之外的人群是癌症发病率和死亡率不成比例较高的人群，这种癌症临床试验公平性的缺失令人不安。当务之急是增加边缘化人群的代表性，以确保开发出有效的治疗方法并公平地应用这些方法。为了改善这些临床试验纳入方面的差距，人们做出了诸多努力，但这些努力面临着一系列多因素和多层次的挑战。我们旨在从患者、临床医生、系统和政策层面来审查这些挑战。我们还强调并提出解决方案，以指导未来为实现癌症健康公平而做出的努力。
