The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Are there systematic barriers to participation in cancer treatment trials by Aboriginal and Torres Strait Islander cancer patients in Australia?
Open accessAbstract
OBJECTIVE: To identify factors that may systematically reduce opportunities for Aboriginal and Torres Strait Islander Australians to participate in cancer clinical trials. METHODS: Analysis of online documents from the Australia and New Zealand Clinical Trials Registry for cancer treatment trials (Phase 3, 4 or Not Applicable) with at least one Australian site, registered in 2014-2018. RESULTS: Among 365 eligible trials, most (89%) had sites only in major cities/inner regional areas, but 39% of Aboriginal and Torres Strait Islander Australians live outside these areas. Seven cancer types accounted for 58% of cancers among Aboriginal and Torres Strait Islander people, but only 46% of trials addressed these cancers. Most trials specified exclusions relating to comorbidities/health status. A substantial minority of trials (38%) explicitly referred to investigator opinion/judgment as a relevant determinant of patient eligibility. CONCLUSION: Aboriginal and Torres Strait Islander patients appear to have a reduced opportunity to participate in trials because of where they live, their type of cancer and their general health status, as well as for less transparent reasons relating to investigator judgment. Implications for public health: Greater transparency and greater scrutiny of barriers to trial participation for Aboriginal and Torres Strait Islander Australians are needed to ensure equitable access.
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“One analysis of a Clinical Trials Registry in Australia and New Zealand established that Aboriginal and Torres Strait Islander people had reduced opportunities to participate in clinical trials [38].”
From Enablers and barriers of clinical trial participation in adult patients from minority ethnic groups: a systematic review (2025) · cites this paper as [38]
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In the citing paper
“Two studies focused on Indigenous communities, specifically in Australia [38], and in the US (Native Hawaiians) [32].”
From Enablers and barriers of clinical trial participation in adult patients from minority ethnic groups: a systematic review (2025) · cites this paper as [38]
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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 [38]
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“Factors contributing to this disparity included the geographical misalignment between trial locations and the residential areas of these communities, as well as the discrepancy between the cancer types studied in trials and those predominantly affecting Aboriginal and Torres Strait Islander people.”
From Enablers and barriers of clinical trial participation in adult patients from minority ethnic groups: a systematic review (2025) · cites this paper as [38]
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In the citing paper
“A total of 12 articles were assessed with a score of below 3. This included two RCTs [61, 66], three non-randomised studies [15, 46, 64], six quantitative descriptive studies [9, 37, 38, 40, 57, 58] and one mixed methods study [60].”
From Enablers and barriers of clinical trial participation in adult patients from minority ethnic groups: a systematic review (2025) · cites this paper as [38]
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Citations
Cites
Implicit bias in healthcare professionals: a systematic review
FitzGerald, C., & Hurst, S. (2017) · BMC Medical Ethics · doi:10.1186/s12910-017-0179-8 · Cited by 2,556
Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302903 · Cited by 2,176
Bonevski, B., Randell, M., Paul, C. L., Chapman, K. L., Twyman, L., Bryant, J., Brozek, I., & Hughes, C. (2014) · BMC Medical Research Methodology · doi:10.1186/1471-2288-14-42 · Cited by 1,495
Barriers to recruiting underrepresented populations to cancer clinical trials: a systematic review
Ford, J. G., Howerton, M. W., Lai, G. Y., Gary, T. L., Bolen, S., Gibbons, M. C., Tilburt, J., Baffi, C., Tanpitukpongse, T. P., Wilson, R. F., et al. (2008) · Cancer · doi:10.1002/cncr.23157 · Cited by 1,083
The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies
Unger, J. M., Cook, E., Tai, E., & Bleyer, A. (2016) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_156686 · Cited by 665
The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies
Unger, J. M., Cook, E. D., Tai, E. W., et al. (2016) · American Society of Clinical Oncology Educational Book · doi:10.14694/edbk_156686 · Cited by 382
A Systematic Review of the Extent and Measurement of Healthcare Provider Racism
Paradies, Y., Truong, M., & Priest, N. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2583-1 · Cited by 263
Barriers and facilitators to participation of minorities in clinical trials.
Schmotzer, G. L. (2012) · PubMed · Cited by 178
Hughson, J., Woodward‐Kron, R. E., Parker, A. V., Hajek, J., Bresin, A., Knoch, U., Phan, T. D., & Story, D. (2016) · Trials · doi:10.1186/s13063-016-1384-3 · Cited by 168
Salman, A., Nguyen, C., Lee, Y., & Cooksey-James, T. (2015) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-015-0198-9 · Cited by 100
Research works printed but not linked: 1
- Sabesan, 2019, An introduction to the Australasian Teletrial Model, Asia-Pac J Clin Oncol., 15, 3
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
“Lastly, many research sites were located in areas difficult for Aboriginal and Torres Strait Islander communities to access or required travel to main cities to access treat-ment and subsequent follow-up visits [38].”
Influential
Metadata
- Authors
- Cunningham, J., & Garvey, G.
- Affiliations
- Menzies School of Health Research (AU)
- Corresponding author
- Cunningham, Joan
- Venue
- Australian and New Zealand Journal of Public Health
- Publisher
- Elsevier BV
- Published
- 2021-02
- Volume
- 45
- Issue
- 1
- Pages
- 39-45
- ISSN
- 1326-0200 (ISSN-L)
- OpenAlex
- W3113868457
- Cited by
- 30
- References
- 14
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 10 · 2023: 3 · 2022: 5 · 2021: 1
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Australian and New Zealand Journal of Public Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Health and Medical Research Council (1153027, 1176651, 1058244)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- Aboriginal and Torres Strait Islander peoples, cancer clinical trials, barriers to clinical trial participation, health equity, inclusion and exclusion criteria, cancer types
- MeSH terms
- Health Equity, Australian Aboriginal and Torres Strait Islander Peoples, Adult, Antineoplastic Agents, Australia, Clinical Trials as Topic, Female, Health Status, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Neoplasms, New Zealand, Referral and Consultation
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- CoChat. (2026). Citation check: Are there systematic barriers to participation in cancer treatment trials by Aboriginal and Torres Strait Islander cancer patients in Australia? https://app.cochat.ai/papers/10.1111/1753-6405.13059
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- Cunningham, J., & Garvey, G. (2021). Are there systematic barriers to participation in cancer treatment trials by Aboriginal and Torres Strait Islander cancer patients in Australia? Australian and New Zealand Journal of Public Health. https://doi.org/10.1111/1753-6405.13059
