Anderson Rebecca, Popovic Aleksander, Davis Matthew, Kovac Evan
Division of Urology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Transl Cancer Res. 2024 Nov 30;13(11):6430-6437. doi: 10.21037/tcr-24-868. Epub 2024 Oct 10.
Minorities participate less than White people in a variety of research settings limiting the generalizability of the research results. The driving forces behind the lower participation rates are multifactorial and vary by race. Further compounding these driving forces are past inequities and violations of trust by the healthcare system. Addressing these issues is crucial to equitably accruing within clinical trials and subsequently addressing the lack of generalizable results being produced. Despite legislation being enacted to increase the enrollment of minorities in clinical trials, the participation rates remain low with cancer clinical trials being particularly disparate in terms of equitable representation. As prostate cancer disproportionately affects Black men, it is imperative that prostate cancer clinical trials enroll an equitable number of Black men. Previous trials including the Prostate, Lung, Colorectal, and Ovarian multicenter randomized trial and the Prostate Cancer Prevention Trial both involved concerted efforts to address the relatively low participation rate of minority men, but both were not successful in that regard. To facilitate equal access and ensure the appropriate participation of minorities in prostate cancer clinical trials, various interventions from additional safety assurances to consenting patients as a family unit have been employed, depending on the community. Overall, progress is being made in equitably accruing clinical trials, but there remains more work to be done.
在各种研究环境中,少数族裔的参与度低于白人,这限制了研究结果的普遍性。参与率较低背后的驱动因素是多方面的,且因种族而异。此外,医疗保健系统过去的不公平现象和对信任的破坏进一步加剧了这些驱动因素。解决这些问题对于在临床试验中公平招募参与者并随后解决缺乏可推广结果的问题至关重要。尽管已颁布立法以增加少数族裔在临床试验中的入组人数,但参与率仍然很低,癌症临床试验在公平代表性方面尤其存在差异。由于前列腺癌对黑人男性的影响尤为严重,因此前列腺癌临床试验必须公平招募一定数量的黑人男性。以前的试验,包括前列腺、肺、结肠和卵巢多中心随机试验以及前列腺癌预防试验,都曾共同努力解决少数族裔男性参与率相对较低的问题,但在这方面都没有成功。为了促进平等参与并确保少数族裔在前列腺癌临床试验中的适当参与,根据不同社区的情况,采取了各种干预措施,从提供额外的安全保障到将患者作为一个家庭单位进行知情同意。总体而言,在公平招募临床试验参与者方面正在取得进展,但仍有更多工作要做。
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