Oncology Rounds

Why don't patients enroll in clinical trials?

by Ashley Riley

With the announcement of Vice President Biden’s Cancer Moonshot earlier this year, there’s been a resurgence of national interest in cancer research, and for good reason. Clinical trials are responsible for most of the advances we’ve made in cancer treatment so far, and will be critical in helping us continue to improve treatment. But despite the importance of clinical trials, relatively few cancer patients participate in them. To figure out why, Memorial Sloan Kettering surveyed almost 2,000 consumers and providers—keep reading to find out what they learned.

Survey finds many consumers unlikely to enroll in clinical trials

Memorial Sloan Kettering Cancer Center commissioned a national survey of more than 1,500 Americans aged 18-69 and almost 600 practicing physicians in October and November of 2015. They found that only 35% of consumers were “likely” to enroll in a clinical trial and only 40% had positive overall impressions of clinical trials.

Concern about side effects, safety, and finances top barriers to trial enrollment

The survey also asked why consumers might be hesitant to participate in a clinical trial. Concern over potential side effects and the safety of clinical trials was the top barrier to participation among Americans (55%). This comes as no surprise to physicians – 63% reported that when discussing clinical trials with their patients, fear about side effects and safety was the biggest barrier to enrollment. Additionally, almost half of consumers cited financial concerns and inconvenience of trial locations as key barriers. Notably, a lack of understanding about clinical trials persists—46% of respondents indicated concern over receiving a placebo as a barrier to participation.

Physician practices also contribute to low clinical trial participation

Consumer concerns aren’t the only barrier to clinical trial enrollment. Memorial Sloan Kettering’s survey also asked practicing physicians about their views on clinical trials. More than half of them said that they only considered clinical trials late in treatment, and 28% reported that they viewed clinical trials as a last resort treatment option. Only 32% of surveyed physicians indicated discussing clinical trial options with their patients at the start of treatment.

Education key to increasing enrollment

The good news is that education can make a difference. Memorial Sloan Kettering found that the number of consumers with a positive perception of clinical trials increased by 50% after they read a simple statement defining clinical trials. This suggests that many providers could take simple steps to improve education on and acceptance of trials.

Similarly, we need to educate physicians that clinical trials are not just a last resort treatment option for cancer patients. It’s important that they discuss clinical trials with patients from the beginning of the treatment process.

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