Disparities in Cancer Clinical Trials: An Analysis of Comprehensive Cancer Control Plans

INTRODUCTION: Disparities in enrollment of adults in cancer clinical trials are well documented, but little is known about the attention given to this topic in comprehensive cancer control (CCC) plans. We assessed the extent to which CCC plans address disparities in clinical trials and whether jurisdictions whose plans address disparities also mandate third-party reimbursement for clinical trial participation. METHODS: We analyzed 57 CCC plans identified from Cancer PLANET (Plan, Link, Act, Network with Evidence-based Tools) and Cancerplan.org from April through December 2007. We searched plans for general and disparity-specific content regarding clinical trials and analyzed the content for emergent themes. We assessed frequencies of themes, patterns between themes, and patterns between themes and laws. We reviewed third-party reimbursement laws, as of September 2007, as recorded by the National Cancer Institute's State Cancer Legislative Database. RESULTS: Fifty-five (96%) CCC plans had content regarding clinical trials. Of the 39 (71%) plans that specifically addressed disparities, 13 (33%) were in a state with laws mandating third-party reimbursement. Increasing participation and education, awareness, and outreach were the most common themes identified. CONCLUSION: Although many CCC plans address disparities in clinical trials, few of those plans are in jurisdictions that have third-party reimbursement laws.