Journal
CANCER
Volume 121, Issue 24, Pages 4398-4406Publisher
WILEY
DOI: 10.1002/cncr.29669
Keywords
adolescent; clinical oncology; clinical trial as topic; young adult
Categories
Funding
- Dear Jack Foundation
- David Stroud Postgraduate Fellowship Fund
- California Department of Public Health as part of cancer reporting program [103885]
- National Cancer Institute's Surveillance, Epidemiology, and End Results program [HHSN261201000140C, HHSN261201000035C, HHSN261201000034C]
- Centers for Disease Control and Prevention's National Program of Cancer Registries [U58DP003862-01]
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BACKGROUND: Poor accrual to cancer clinical trials may contribute to the lower improvement in survival observed for adolescents and young adults (AYAs) (those aged 15-39 years) with cancer. This has been difficult to quantify without reliable mechanisms to link incident cases with study enrollments. Using unique resources available at their National Cancer Institute-designated comprehensive cancer center, the authors compared the percentage of AYAs, children, and older adults enrolled onto cancer clinical trials and determined predictors of enrollment. METHODS: Patients diagnosed with cancer from January 2008 through December 2012 at 1 pediatric and 2 adult University of Southern California hospitals were identified through the California Cancer Registry and individually linked to institutional trial enrollment databases. The availability of clinical trials was assessed. RESULTS: Across the center, the enrollment percentage for AYAs (6%) was equal to that of older adults (6%), but was less than that for children (22%) (P<.01). Within the children's hospital, the AYA enrollment percentage was also less than that for children (15% vs 23%, respectively; P<.01). On multivariate analysis, diagnosis and site of care were found to be predictive of AYA enrollment onto therapeutic and nontherapeutic studies. Hispanic and Asian/Pacific Islander individuals were more likely to enroll onto nontherapeutic studies compared with non-Hispanic whites, but no racial/ethnic difference was observed for therapeutic studies. CONCLUSIONS: In the current study, the percentages of AYAs and older adults enrolled onto therapeutic trials were low but similar. Diagnosis, site of care, and race/ethnicity appear to be predictive of enrollment. Prospective mechanisms must be instituted to capture reasons for nonenrollment of AYAs and develop corrective interventions. (C) 2015 American Cancer Society.
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