Income tied to cancer study participation

Low-income cancer patients, including those who are on Medicare, are far less likely to participate in clinical trials than higher-income patients, according to a study in the Journal of Clinical Oncology.

Researchers from the Fred Hutchinson Cancer Research Center in Seattle looked at the socioeconomic and demographic information of 5,499 patients who participated in trials from 2007-2011. Patients were surveyed via an Internet-based treatment decision tool, using items about treatment, tolerability of treatment, convenience, and cost.

Of those patients, 40% discussed clinical trials with their physician, 45% of those discussions led to offers of clinical trial participation, and about half of those offers led to trial participation. Overall participation, however, was 9%. Univariate models showed that patients with lower income and education were less likely to participate, including older patients on Medicare. In multivariable models, income was a significant predictor of participation. Low-income patients showed far more cost concerns.1

“A better understanding of why income is a barrier may help identify ways to make clinical trials better available to all patients and would increase the generalizability of clinical trial results across all income levels,” the study authors note.


  1. Unger JM, Hershman DL, et al. Patient income level and cancer clinical trial participation. J Clin Oncol. 2013 Jan 7. [Epub ahead of print]