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Are ethnic and racial minority women less likely to participate in clinical trials?
Abstract
Objectives Given the disparity that exists in enrollment of minorities to oncology clinical trials, the objective of our study was to assess whether race is associated with willingness to participate in gynecologic oncology clinical trials in a rural Southern academic medicine setting. Our secondary aim was to determine whether willingness to participate is impacted by an educational intervention.Methods A single institution prospective survey study was performed at an academic medical center. Women presenting to the gynecologic oncology clinic with a current or prior diagnosis of gynecologic malignancy were approached to participate. The validated Attitudes to Randomized Trials Questionnaire (ARTQ) assessed willingness to participate in clinical trials. Relevant demographic and clinical data were abstracted. Characteristics were compared between those willing and unwilling to participate in clinical trials with a chi-square test for categorical variables and Wilcoxon rank sum tests for continuous data.Results We enrolled 156 participants (50% White, 50% non-White) from May 2017 to January 2018. The minority group included 35% non-Hispanic Black, 9% Hispanic, 4% Asian, and 2% other. Median age was 63 years with endometrial cancer being the most common diagnosis (48%). On initial screen, only 35% were willing to participate in a clinical trial. Willingness to participate did not differ between race, age, marital status, education level, cancer type, stage, or mode of treatment. Rates improved to 82% after being provided additional educational information. Following education, White women and those with more education were significantly more willing to participate in clinical trials than their minority and less educated counterparts.Conclusions Willingness to participate improved among all sub-categories following an educational intervention. The increase in willingness was less robust among racial and ethnic minorities, suggesting that different tools are needed for recruitment of minorities to gynecologic oncology clinical trials.
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“Fourteen studies reported on why certain patients may have been overlooked for clinical trial participation [12, 17, 38, 42, 44, 45, 52–55, 59, 63, 66, 69].”
From Enablers and barriers of clinical trial participation in adult patients from minority ethnic groups: a systematic review (2025) · cites this paper as [55]
Citations
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Minority participation in Gynecologic Oncology Group (GOG) Studies
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Cited by
Alarcón Garavito, G. A., Gilchrist, K., Ciurtin, C., Khanna, S., Chambers, P., McNally, N., Merivale, E., Carr, E., Yu, R., & Vindrola-Padros, C. (2025) · Trials · doi:10.1186/s13063-025-08769-y · Cited by 42
“Fourteen studies reported on why certain patients may have been overlooked for clinical trial participation [12, 17, 38, 42, 44, 45, 52–55, 59, 63, 66, 69].”
Brown, O., Siddique, M., Mou, T., Boniface, E. R., Volpe, K. A., Cichowski, S. B., & AUGS Disparities Special Interest Group (2020) · Urogynecology · doi:10.1097/spv.0000000000000992 · Cited by 40
Wagar, M. K., Mojdehbakhsh, R. P., Godecker, A. L., Rice, L. W., & Barroilhet, L. M. (2022) · Gynecologic Oncology · doi:10.1016/j.ygyno.2022.01.032 · Cited by 33
Steinberg, J. R., Turner, B. E., DiTosto, J. D., Weeks, B. T., Young, A. M. P., Lu, C. F., Wolgemuth, T. E., Holder, K., Laasiri, N., Squires, N. A., et al. (2022) · JAMA Surgery · doi:10.1001/jamasurg.2022.6600 · Cited by 34
Contraceptive content shared on social media: an analysis of Twitter
Huang, M., Gutiérrez‐Sacristán, A., Janiak, E., Young, K., Starosta, A., Blanton, K. L., Azhir, A., Goldfarb, C. N., Kuperwasser, F., Schaefer, K. M., et al. (2024) · Contraception and Reproductive Medicine · doi:10.1186/s40834-024-00262-2 · Cited by 31
“This is particularly important as people of racial and ethnic minority backgrounds have higher rates of unintended pregnancies but are less likely to be participants in traditional health research [50, 51].”
Background
Metadata
- Authors
- Patel, S. N., Staples, J. N., Garcia, C., Chatfield, L., Ferriss, J. S., & Duska, L.
- Affiliations
- University of Alabama at Birmingham (US)
- University of Virginia (US)
- Kaiser Permanente (US)
- Walter Reed National Military Medical Center (US)
- Johns Hopkins University (US)
- Corresponding author
- Staples, Jeanine N.
- Venue
- Gynecologic Oncology
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 157
- Issue
- 2
- Pages
- 323-328
- ISSN
- 0090-8258 (ISSN-L)
- OpenAlex
- W3014981905
- Cited by
- 44
- References
- 27
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 10 · 2022: 7 · 2021: 5 · 2020: 2
- FWCI
- 4.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- Locations
- Gynecologic Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Keywords
- clinical trial participation, racial and ethnic minorities, minority recruitment, willingness to participate, educational intervention, endometrial cancer, racial disparities
- MeSH terms
- Aged, Asian, Black or African American, Ethnicity, Female, Hispanic or Latino, Humans, Middle Aged, Minority Groups, Patient Education as Topic, Prospective Studies, Surveys and Questionnaires, United States, Randomized Controlled Trials as Topic, Endometrial Neoplasms, Black People, White People
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- The paper
- Patel, S. N., Staples, J. N., Garcia, C., Chatfield, L., Ferriss, J. S., & Duska, L. (2020). Are ethnic and racial minority women less likely to participate in clinical trials? Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2020.01.040
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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