Deprived patients underrepresented in cancer trials

Patients who are socially and/or economically deprived are less likely to be referred to clinical trials for cancer treatment, according to research from the NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.

The study, published today in the Journal of Clinical Oncology, found that patients from the most deprived areas were only half as likely to be referred for a clinical trial as better-off patients.

Further investigation is needed to determine why this is. There are a number of potential reasons: it could be due to lack of information given to deprived patients, or because they are unaware that they may be eligible to take part, or because they are less suitable for trials because they have other illnesses.

“The good news is that once patients are referred to our Phase 1 trials unit, socioeconomic background has no impact on whether or not they are enrolled on a trial – but it’s important that all patients have equal access in the first place,” says Dr James Spicer, a consultant in medical oncology at Guy’s and St Thomas’, and Deputy Director of the Clinical Research Facilities at the NIHR Guy’s and St Thomas’ Biomedical Research Centre. “The next step is to find out why deprived patients are overlooked, so we can address this issue.”

Clinical trials for new cancer treatments ideally should have a representative sample of patients to ensure that results apply to the general population.

The researchers studied 430 patients referred to their unit, and compared with 10,784 cancer cases from the Thames Cancer Registry, which collects, analyses and disseminates data on newly diagnosed cancer in residents of London, Surrey, Sussex and Kent.

The research was based on the government’s Index of Multiple Deprivation (IMD), which rates the socioeconomic status of each postcode in the UK. Scores are calculated based on census information about income, employment, crime levels, and access to health services.

Being involved in a Phase 1 trial means a patient receives pioneering treatment when conventional therapy is ineffective.