Lower-Income Patients Less Likely to Participate in Clinical Trials

ASCO Annual Meeting
June 3, 2012

A large national survey of people with cancer showed that a patient's income strongly predicts whether he or she will participate in a clinical trial. A clinical trial is a research study involving people. A clinical trial may focus on new treatments, new methods to prevent cancer, and ways to manage the symptoms and side effects of cancer and cancer treatment.

This survey used an online treatment decision tool to collect information from 5,499 patients newly diagnosed with breast, lung, colorectal, or prostate cancer. Researchers found that patients who made less than $50,000 a year were 30% less likely to participate in a clinical trial than those with a higher income. In addition, patients whose income was less than $20,000 a year were 44% less likely to participate in a clinical trial than patients with an income higher than $20,000 a year. Among the patients with a lower income, researchers found that concerns about how to pay for participating in a clinical trial were much higher.

Researchers also found that 40% of patients had talked about clinical trials with their doctors. Out of these patients, 45% were offered treatment in a clinical trial, and 51% of those offered treatment in a clinical trial participated in one. This level of clinical trial participation is much higher than that of the overall survey, which was 9%. This means that discussing clinical trials is an important factor in determining whether patients receive treatment in a clinical trial.

What this means for patients

“Previous research has shown some association between cancer clinical trial participation and income, but the income was not reported by the patients. This is the first time in a large, national study that we have actual patient-reported income on which to base this finding,” said the study's lead author, Joseph M. Unger, MS, PhC, a health services researcher and statistician with the SWOG Statistical Center at the Fred Hutchinson Cancer Research Center in Seattle, Washington. “Our study found that after accounting for all factors such as age, education, sex, race, medical conditions, and distance to a clinic, income on its own was associated with a patient's clinical trial participation.”

This study did not look at the specific cost concerns of patients with lower incomes. However, possible financial challenges may include co-pays and co-insurance and taking time off work to go for a clinic visit. These costs are also often associated with any cancer treatment. It's important to talk with your doctor about your treatment options, including participating in clinical trials and the costs you may need to pay.

Questions to Ask Your Doctor

  • What type of cancer do I have? What is the stage?
  • What are the treatment options?
  • What clinical trials are open to me?
  • Where can I learn more about clinical trials?
  • If I'm worried about the cost of my cancer care, who can help me with those concerns?

For More Information

Clinical Trials

Managing the Cost of Cancer Care

Making Treatment Decisions