Poor Geographic Accessibility of Advanced Cancer Clinical Trial Sites
It is estimated that approximately 2% to 7% of U.S. adult patients with cancer participate in clinical trials, and poor geographic accessibility of clinical trial sites contributes to this low participation. In a study reported in JAMA Internal Medicine, Galsky et al found that approximately 40% to 50% of patients with metastatic breast, prostate, colorectal, and lung cancer need to drive over 1 hour one-way to reach a trial site.
Study Details
In the study, the one-way driving time from each U.S. zip code to the nearest breast, prostate, colorectal, or non–small cell lung cancer (NSCLC) trial site, identified through ClinicalTrials.gov, was calculated using Microsoft MapPoint 2013. Calculations for each cancer type used zip code as the point of origin and the zip code of the nearest trial site as the destination.
Driving Times
The analysis included totals of 40,981, 28,699, 50,641, and 157,183 patients with metastatic breast cancer, prostate cancer, colorectal cancer, and NSCLC. It was found that 45.6%, 50.2%, 52.2%, and 38.4% of patients with metastatic breast cancer, prostate cancer, colorectal cancer, and NSCLC needed to drive over 1 hour one-way to access a clinical trial site; one-way drives of 1 to 2 hours were necessary for 27.8%, 33.9%, 33.6%, and 28.7% of patients respectively.
One-way drives of over 1 hour were necessary for over 80% of breast cancer and colorectal cancer patients in the West South Central region and for 60% to 80% of patients with breast cancer in the Mountain and East South Central regions, patients with prostate cancer in the Mountain, West South Central, West North Central, and East South Central regions, colorectal cancer patients in the Mountain and West North Central regions, and NSCLC patients in the Mountain and West South Central regions.
The investigators concluded: “Our findings suggest that innovative approaches are needed to improve the geographic accessibility of trials for patients with advanced cancer in the United States.”
Matthew D. Galsky, MD, of Icahn School of Medicine at Mount Sinai, is the corresponding author for the JAMA Internal Medicine article.
The study was supported by a Prostate Cancer Foundation and Young Investigator Award and a Clinical and Translational Science Award KL2 Faculty Scholars Award. The authors reported no conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
