Sociodemographic Factors and Cancer Clinical Trial Enrollment Among Adolescents and Young Adults

Purpose – Adolescents and young adults (AYAs) have experienced slower increases in cancer survival rates compared to those of other age groups. One potential explanation for this limited improvement is the low rate of AYA enrollment in cancer clinical trials. This study examines the possible association of insurance type, race, ethnicity, and marital status with AYA clinical trial enrollment in the hope that our findings will help providers to improve enrollment among AYAs. Methods – We conducted a retrospective cohort study of AYAs treated for cancer at UNC-affiliated hospitals between April 2014 and April 2019. Data were obtained through the linkage of Carolina Data Warehouse and the UNC Cancer Registry. Potential associations were tested for significance through bivariable analysis. Possible confounders were controlled for in a multivariable analysis. Results – Our final sample included 1,798 patients. Patients without insurance were the most likely of any group to enroll in a trial and were 1.87 times as likely as those with public insurance to enroll [95% CI (1.25, 2.80)]. Individuals with private insurance were 1.32 times as likely as those with public insurance to enroll in cancer clinical trials, although this relationship was borderline significant. Hispanic individuals were about half as likely as non-Hispanic individuals to enroll [95% CI (0.30, 0.95)] Marital status had a borderline significant association with enrollment, with married patients being the most likely to enroll. Conclusion – Health care providers can utilize this information to try to enroll more Hispanic AYAs and AYAs with public insurance in clinical trials. Further research should be conducted to better understand why these disparities in trial enrollment exist among AYAs.Bachelor of Science in Public Healt