Underrepresentation of racial and ethnic minority groups in gynecologic oncology: An analysis of over 250 trials

Michael T. Richardson, Danika Barry, Jecca R. Steinberg, Vineeth Thirunavu, Danielle E. Strom, Kai Holder, Naixin Zhang, Brandon E. Turner, Christopher J. Magnani, Brannon T. Weeks, Anna Marie P. Young, Connie F. Lu, Tierney R. Wolgemuth, Nora Laasiri, Natalie A. Squires, Jill N. Anderson, Beth Y. Karlan, John K. Chan, Daniel S. Kapp, Dario R. RoqueRitu Salani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe the participation of racial and ethnic minority groups (REMGs) in gynecologic oncology trials. Methods: Gynecologic oncology studies registered on ClinicalTrials.gov between 2007 and 2020 were identified. Trials with published results were analyzed based on reporting of race/ethnicity in relation to disease site and trial characteristics. Expected enrollment by race/ethnicity was calculated and compared to actual enrollment, adjusted for 2010 US Census population data. Results: 2146 gynecologic oncology trials were identified. Of published trials (n = 252), 99 (39.3%) reported race/ethnicity data. Recent trials were more likely to report these data (36% from 2007 to 2009; 51% 2013–2015; and 53% from 2016 to 2018, p = 0.01). Of all trials, ovarian cancer trials were least likely to report race/ethnicity data (32.1% vs 39.3%, p = 0.011). Population-adjusted under-enrollment for Blacks was 7-fold in ovarian cancer, Latinx 10-fold for ovarian and 6-fold in uterine cancer trials, Asians 2.5-fold in uterine cancer trials, and American Indian and Alaska Native individuals 6-fold in ovarian trials. Trials for most disease sites have enrolled more REMGs in recent years – REMGs made up 19.6% of trial participants in 2007–2009 compared to 38.1% in 2016–2018 (p < 0.0001). Conclusion: Less than half of trials that published results reported race/ethnicity data. Available data reveals that enrollment of REMGs is significantly below expected rates based on national census data. These disparities persisted even after additionally adjusting for population size. Despite improvement in recent years, additional recruitment of REMGs is needed to achieve more representative and equitable participation in gynecologic cancer clinical trials.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalGynecologic oncology
Volume181
DOIs
StatePublished - Feb 2024

Keywords

  • Gynecologic cancers
  • Race and ethnicity
  • Time trends
  • Trial enrollment
  • Underrepresentation

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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