Photo Credit: Jelena Stanojkovic

Underscoring how trials can benefit all members of a community and discussing spirituality may improve enrollment of Black patients in cancer clinical trials.

In a cross-sectional, descriptive study presented at the 2024 annual meeting of the American Society for Radiation Oncology, the researchers identified factors impacting clinical trial participation among Black patients with cancer.

“Despite national mandates to increase participation of underrepresented racial and ethnic minorities in clinical trials, successful recruitment of these marginalized groups remains low,” investigators noted.

Further, there has been a decline in enrollment in cancer-related clinical trials among Black participants, and the etiology remains unclear.

The authors aimed to understand better the psychosocial factors impacting Black patients with cancer when choosing to participate in clinical research. A questionnaire was administered to 97 patients who completed definitive radiation treatment with curative malignancies across many cancer types.

Benefits of Clinical Trials Unclear for Black Patients

Black participants comprised 30% of the total patient population (n=42). These patients were less likely to be married (P=0.002) and were more likely to live with family (P=0.004), have a lower median income (P<0.001), and have a larger mean Charlson comorbidity index (P=0.017) compared with non-Black patients. There was no difference in education, employment status, cancer stage, or treatments rendered between the cohorts, and both groups were equally asked to participate in a clinical trial.

The investigators found that Black patients with cancer were more likely to agree with statements that illness is determined by God’s will (P=0.001) and that God determines wellness, not research (P<0.001) compared with non-Black patients. Further, 20% of Black participants agreed that research harms minorities compared with 0% of non-Black participants (P<0.001), and one-third of Black participants thought that research would provide more information about their health that they would rather not know about (P=0.037). Black participants reported feeling like there was nothing for them (P=0.038) or their community (P=0.031) to gain by participating in research. However, 90% of both Black and non-Black patients with cancer reported trusting their cancer team.

“Since our study showed significantly different psychosocial factors impacting Black cancer patients, namely those tied to spirituality and community, it’s crucial that researchers become capable of having conversations with their patients of color on these matters,” Gomez said. “If the whole research team is competent in doing so, patients may feel more comfortable with the idea of clinical research and have the opportunity to voice concerns that they are not used to being asked about.”