Most Americans Reluctant to Enroll in Clinical Trials

Lack of enrollment in clinical trials hinder advancement of cancer therapy.

The lack of participation in clinical trials has been an ongoing issue, as a recent study reveals that a majority of Americans are unlikely to enroll in a clinical trial.

The survey was conducted by the Memorial Sloan Kettering Cancer Center (MSK) and involved more than 1500 consumers and almost 600 physicians.

Researchers found that only 35% of Americans reported that they were “likely” to enroll in a trial, while other studies have shown that only 4% of cancer patients enroll in trials nationally and annually.

“When it comes to advancing cancer care, clinical research is the rocket fuel for better treatments, more accurate diagnoses, and, ultimately, cures,” said researcher José Baselga, MD, PhD, physician-in-chief and chief medical officer at MSK. “If this trend of low enrollment continues, we will face a crisis in cancer research and discovery. Further education is the key to participation and progress.”

Participant concerns regarding why they are unlikely to enroll in a clinical trial varied, and included 55% who worried over safety and side effects; 50% unsure of insurance and out-of-pocket costs; 48% who had inconvenient trial locations; 46% concerned with getting a placebo; 35% skeptical of treatment that hasn’t been proven to work; and 34% who didn’t want to feel like guinea pigs.

Physicians reported the biggest barriers for patient participation as side effect and safety worries, receiving the placebo, and the concern of patients not wanting to feel like guinea pigs.

“While concerns regarding clinical trials are understandable, it is critical that the cancer community address common myths and misunderstandings around issues like effectiveness, safety, use of placebo, and at which point in treatment a trial should be considered,” said researcher Paul Sabbatini, MD, deputy physician-in-chief for Clinical Research at MSK. “For example, the vast majority of clinical trials do not involve a placebo.”

Although there are numerous trials available to patients during the earliest phases of treatment, the survey found that of the 600 participating physicians, 56% said they considered clinical trials late in the treatment and 28% considered it as a last resort of treatment. Only 32% of physicians reported discussing clinical trials with their patients at the start of treatment.

Despite the fears associated with a patient entering into a clinical trial, 74% indicated the importance of a variety of clinical trials that are offered when considering a hospital for cancer treatment. There were 72% who saw no difference in care between hospitals with clinical trials and those without.

“When faced with cancer, patients want to know they have multiple options available to them, and this includes clinical trials,” Sabbatini said. “For example, participating in a clinical trial at a place like Memorial Sloan Kettering offers patients the opportunity to receive drugs or therapies years before they are more widely available.”