• A recent study found that Black and Hispanic populations are underrepresented in lung cancer clinical trials when compared to the number of lung cancer cases in the United States.
• Women are also underrepresented compared to men in lung cancer clinical trials.
• More minorities have participated in clinical trials in recent years compared to the early 2000s.

Black and Hispanic populations remain underrepresented in lung cancer clinical trials, although participation has increased in recent years, a new study found. Researchers from the University of California, San Diego, found that underrepresentation of minorities and women occurs in clinical trials for many kinds of cancer, although these trends are changing.

Diversity in Cancer Clinical Trials

Women and minorities have historically participated less in clinical trials, despite the efforts of the National Institutes of Health (NIH) to increase representation. In 1993, the NIH enacted the Revitalization Act to encourage these groups to participate in NIH-sponsored studies — it was most recently updated in 2017. The National Cancer Institute has also created its own initiative to promote diversity in its trials.

Cancer is the second leading cause of deaths in the United States, affecting people from all backgrounds. Representation in clinical trials helps doctors and researchers better understand how different treatments affect people depending on their sex or gender and their social, economic, racial, and ethnic backgrounds.

Without the participation of minority groups and women, clinical trials cannot accurately study how effective treatments are. This can lead to gaps in treatment between different groups. The study authors looked at the representation of participants in clinical trials broken down by age, sex, and racial and ethnic background to determine if there has been an increase in participation from women and minorities.

Recent research also has identified disparities in lung cancer screening and survival rates.

Black, Hispanic Populations Underrepresented in Lung Cancer Trials

The study authors looked at participants in clinical trials that ran from 2000 to 2019 — specifically in trials for lung, breast, colorectal, or prostate cancer. In total, the study included 242,720 participants in the following groups:

• 81.3 percent non-Hispanic white participants
• 8.7 percent Black participants
• 4.8 percent Hispanic participants
• 2.8 percent Asian and Pacific Islander participants
• 0.3 percent American Indian and Alaska Native participants
• 2 percent other

The authors determined the total number of lung cancer cases in the U.S. from 2015 to 2017 and compared the total number of participants in lung cancer clinical trials.

When comparing participants to actual lung cancer cases, Black and Hispanic participants were underrepresented and were 17 percent and 34 percent less likely to be in lung cancer trials, respectively. Women were also 11 percent less likely to participate in lung cancer clinical trials compared to men.

Changes in Clinical Trial Participation Over Time

The study also compared the time span between 2000 to 2004 and between 2015 to 2019 to look for changes in participation from different groups over time. Overall, there was an improvement in diversity in lung cancer clinical trials — Black, Hispanic, and Asian and Pacific Islander populations all increased in participation. In fact, Hispanic and Asian and Pacific Islander populations were 2 to 3 times more likely to be in clinical trials.

Overall, the study highlights the improvements in participation for minority groups and women over the past 20 years. However, some populations remain underrepresented despite the growing number of lung cancer cases. The authors also noted their study does not include any industry-sponsored clinical trials, only those sponsored by the National Cancer Institute.