Abstract
Background: The Dan L Duncan Cancer Center (DLDCC) is located in Houston, Texas, and provides care to uninsured and minority patients in several large hospitals including Ben Taub General Hospital, The Michael E. DeBakey VA Medical Center, and Texas Children's Hospital. The catchment area for the DLDCC is Harris County, an urban area with a population of nearly 4 million; approximately 18% of county residents are African American and 39% are Hispanic. While the percentage of African Americans in Harris County is nearly equal in all age groups, Hispanics make up nearly 45% of residents less than 30 years old, but only 10% of residents over 60, those most likely to develop cancer. One-third of the county population has no health insurance.
Objective: In 2006 the DLDCC set out to increase overall enrollment to therapeutic clinical trials while maintaining enrollment of patients belonging to racial and ethnic minorities.
Methods: A four-pronged strategy was used to maintain and improve accrual of racial and ethnic minority patients to cancer-related clinical trials while increasing overall accrual. First, the DLDCC invested significant resources in establishing research infrastructure in the hospitals including hiring bilingual coordinators and nurses, translating consents into Spanish, and underwriting the cost for conduct of NCI-sponsored trials. Second, the DLDCC partnered with hospitals to make office space available for research personnel, to provide discounted investigational pharmacy services and to obtain access to laboratory and imaging data and pathology samples. Third, the DLDCC introduced programs to make minority residents aware of clinical trials and build relationships and trust in the community including the establishment of a community advisory board, sponsorship of plays by minority playwrights that carry a cancer message, sponsorship of community health events, and creation of clinical trials newsletters and websites. Finally, the DLDCC pioneered and gained IRB approval for a form designed to collect accurate racial and ethnic data from trial participants.
Results: Overall enrollment to DLDCC therapeutic clinical trials increased by more than 50% between 2005/2006 and 2009 to an average of 13.4% of new cancer patients enrolled on trial. In 2009, 16.8% of subjects enrolled to therapeutic trials were African American, and 35.4% were Hispanic. Accrual of minority subjects was equivalent in pediatric and adult programs and on therapeutic and nontherapeutic trials.
Conclusion: Recruitment of pediatric and adult members of underserved minorities to clinical trials is possible with targeted strategies, dedicated research staff, hospital partnership and community involvement.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A44.
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