Enrollment of Older Patients in Cancer Treatment Trials in Canada: Why is Age a Barrier?

Purpose: To evaluate the enrollment of older patients (≥ 65 years) in Canadian cancer treatment trials and compare accrual of older patients in Canada and the United States. Patients and Methods: A retrospective analysis of the number of older patients enrolled in National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) treatment trials between 1993 and 1996 was performed. These rates were compared with the corresponding rates in the general population of patients who were ≥ 65 years old and had cancer, obtained from Statistics Canada, and those published by the Southwest Oncology Group (SWOG) in the United States. Results: Between 1993 and 1996, 4,174 patients were enrolled onto 69 NCIC CTG trials of 16 tumor types. Older patients accounted for 22% of trial enrollees, compared with 58% of the Canadian population with cancer. This discrepancy existed in all cancer types except for multiple myeloma. The percentages of older patients enrolled were also analyzed by study type: 15% in adjuvant trials, 25% in metastatic trials, 29% in investigational new drug trials, 24% in phase I trials, and 21% in supportive care trials. The overall proportion of older patients enrolled onto Canadian trials (22%) was slightly lower than that in SWOG trials (25%). Conclusion: Age remains a barrier for accrual onto cancer treatment trials, even when reimbursement is not an issue. Strategies to overcome this barrier, including the implementation of trials specifically tailored to patients aged ≥ 65 years, are prudent in light of our aging population.

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How Sociodemographics, Presence of Oncology Specialists, and Hospital Cancer Programs Affect Accrual to Cancer Treatment Trials

Journal of Clinical Oncology ◽

10.1200/jco.2002.08.056 ◽

2002 ◽

Vol 20 (8) ◽

pp. 2109-2117 ◽

Cited By ~ 331

Author(s):

Warren B. Sateren ◽

Edward L. Trimble ◽

Jeffrey Abrams ◽

Otis Brawley ◽

Nancy Breen ◽

...

Keyword(s):

United States ◽

Clinical Trials ◽

Health Insurance ◽

Cancer Treatment ◽

Cancer Patients ◽

Asian American ◽

The United States ◽

Health Maintenance ◽

Treatment Trials ◽

The Impact

PURPOSE: We chose to examine the impact of socioeconomic factors on accrual to National Cancer Institute (NCI)–sponsored cancer treatment trials. PATIENTS AND METHODS: We estimated the geographic and demographic cancer burden in the United States and then identified 24,332 patients accrued to NCI-sponsored cancer treatment trials during a 12-month period. Next, we examined accrual by age, sex, geographic residence, health insurance status, health maintenance organization market penetration, several proxy measures of socioeconomic status, the availability of an oncologist, and the presence of a hospital with an approved multidisciplinary cancer program. RESULTS: Pediatric patients were accrued to clinical trials at high levels, whereas after adolescence, only a small percentage of cancer patients were enrolled onto clinical trials. There were few differences by sex. Black males as well as Asian-American and Hispanic adults were accrued to clinical trials at lower rates than white cancer patients of the same age. Overall, the highest observed accrual was in suburban counties. Compared with the United States population, patients enrolled onto clinical trials were significantly less likely to be uninsured and more like to have Medicare health insurance. Geographic areas with higher socioeconomic levels had higher levels of clinical trial accruals. The number of oncologists and the presence of approved cancer programs both were significantly associated with increased accrual to clinical trials. CONCLUSION: We must work to increase the number of adults who enroll onto trials, especially among the elderly. Ongoing partnership with professional societies may be an effective approach to strengthen accrual to clinical trials.

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EPID-07. ACCESS TO GLIOBLASTOMA CLINICAL TRIALS FOR RURAL PATIENTS IN THE UNITED STATES FROM 2010–2020

Neuro-Oncology ◽

10.1093/neuonc/noaa215.325 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii79-ii79

Author(s):

Kathryn Nevel ◽

Samuel Capouch ◽

Lisa Arnold ◽

Katherine Peters ◽

Nimish Mohile ◽

...

Keyword(s):

United States ◽

Clinical Trials ◽

Rural Communities ◽

The United States ◽

Interventional Treatment ◽

Phase Ii Trials ◽

Treatment Trials ◽

Rural Sites ◽

Rural Patients ◽

Urban Sites

Abstract BACKGROUND Patients in rural communities have less access to optimal cancer care and clinical trials. For GBM, access to experimental therapies, and consideration of a clinical trial is embedded in national guidelines. Still, the availability of clinical trials to rural communities, representing 20% of the US population, has not been described. METHODS We queried ClinicalTrials.gov for glioblastoma interventional treatment trials opened between 1/2010 and 1/2020 in the United States. We created a Structured Query Language database and leveraged Google application programming interfaces (API) Places to find name and street addresses for the sites, and Google’s Geocode API to determine the county location. Counties were classified by US Department of Agriculture Rural-Urban Continuum Codes (RUCC 1–3 = urban and RUCC 4–9 = rural). We used z-ratios for rural-urban statistical comparisons. RESULTS We identified 406 interventional treatment trials for GBM at 1491 unique sites. 8.7% of unique sites were in rural settings. Rural sites opened an average of 1.7 trials/site and urban sites 2.8 trials/site from 1/2010–1/2020. Rural sites offered more phase II trials (63% vs 57%, p= 0.03) and fewer phase I trials (22% vs 28%, p= 0.01) than urban sites. Rural locations were more likely to offer federally-sponsored trials (p< 0.002). There were no investigator-initiated or single-institution trials offered at rural locations, and only 1% of industry trials were offered rurally. DISCUSSION Clinical trials for GBM were rarely open in rural areas, and were more dependent on federal funding. Clinical trials are likely difficult to access for rural patients, and this has important implications for the generalizability of research as well as how we engage the field of neuro-oncology and patient advocacy groups in improving patient access to trials. Increasing the number of clinical trials in rural locations may enable more rural patients to access and enroll in GBM studies.

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A Bibliometric Analysis of the Top Cited Articles in Sports and Exercise Medicine

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120969902 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712096990

Author(s):

Omeet Khatra ◽

Armita Shadgan ◽

Jack Taunton ◽

Amir Pakravan ◽

Babak Shadgan

Keyword(s):

United States ◽

Sports Medicine ◽

Controlled Trial ◽

Country Of Origin ◽

Well Being ◽

The United States ◽

Journal Title ◽

Exercise Medicine ◽

Sports And Exercise ◽

Study Type

Background: Although citation analysis is common in many areas of medicine, there is a lack of similar research in sports and exercise medicine. Purpose: To identify and examine the characteristics of the 100 top cited articles in the field of sports and exercise medicine in an effort to determine what components make an article highly influential. Study Design: Cross-sectional study. Methods: The Web of Science, Scopus, and PubMed databases were used to determine the 100 top cited articles from 46 journals in the field of sports and exercise medicine. Each of the 100 articles was then analyzed by 2 independent reviewers, and results were compared. Basic information was collected, including journal title, country of origin, and study type. Different categories were compared using descriptive statistics of counts or percentages. Results: The 100 top cited articles were published in 15 of the 46 identified sports and exercise medicine journals, with the most prolific being Medicine and Science in Sports and Exercise (n = 49), American Journal of Sports Medicine (n = 18), and Sports Medicine (n = 7). In terms of country of origin, the top 3 contributors were the United States (n = 65), Canada (n = 9), and Sweden (n = 8). The most commonly researched anatomic areas were the knee (n = 15) and the brain (n = 3). Narrative reviews were the most common study type (n = 38), and only a single study on the 100 top cited articles list used a randomized controlled trial design. The most prevalent fields of study were exercise science (55% of articles) and well-being (16% of articles). Conclusion: Narrative reviews from the United States and published in English-language journals were the most likely to be highly cited. In addition, the knee was a common anatomic area of study on the top cited list of research in sports and exercise medicine

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55 Malignant primary brain and other central nervous system tumours diagnosed in the Canadian population from 2009 to 2013

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.306 ◽

2018 ◽

Vol 45 (S3) ◽

pp. S16-S17

Author(s):

EV Walker ◽

F Davis ◽

Keyword(s):

United States ◽

Central Nervous System ◽

Nervous System ◽

Brain Tumour ◽

Age Distribution ◽

Paediatric Population ◽

The United States ◽

Incidence Rates ◽

Canadian Population ◽

Cns Tumours

The Canadian Brain Tumour Registry (CBTR) project was established in 2016 with the aim of enhancing infrastructure for surveillance and clinical research to improve health outcomes for brain tumour patients in Canada. We present a national surveillance report on malignant primary brain and central nervous system (CNS) tumours diagnosed in the Canadian population from 2009-2013. Patients were identified through the Canadian Cancer Registry (CCR); an administrative dataset that includes cancer incidence data from all provinces/territories in Canada. Cancer diagnoses are coded using the ICD-O3 system. Tumour types were classified by site and histology using The Central Brain Tumour Registry of the United States definitions. Incidence rates (IR) and 95% confidence intervals (CI) were calculated per 100,000 person-years and standardized to the 2011 census population age-distribution. Overall, 12,115 malignant brain and CNS tumours were diagnosed in the Canadian population from 2009-2013 (IR:8.43;95%CI:8.28,8.58). Of these, 6,845 were diagnosed in males (IR:9.72;95%CI:9.49,9.95) and 5,270 in females (IR:7.20;95%CI:7.00,7.39). The most common histology overall was glioblastoma (IR:4.06;95%CI:3.95,4.16). Among those aged 0-19 years, 1,130 malignant brain and CNS tumours were diagnosed from 2009-2013 (IR:3.36;95%CI:3.16,3.56). Of these, 625 were diagnosed in males (IR:3.32;95%CI:3.34,3.92) and 505 in females (IR:3.08;95%CI:2.81,3.36). The most common histology among the paediatric population was pilocytic astrocytoma (IR:0.73;95%CI:0.64,0.83). The presentation will include: IRs for other histologies, the geographic distribution of cases and a comparison between Canada and the United States.

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Temporal trends in percutaneous coronary intervention outcomes among older patients in the United States

American Heart Journal ◽

10.1016/j.ahj.2013.05.006 ◽

2013 ◽

Vol 166 (2) ◽

pp. 273-281.e4 ◽

Cited By ~ 32

Author(s):

Sunil V. Rao ◽

Connie N. Hess ◽

David Dai ◽

Cynthia L. Green ◽

Eric D. Peterson ◽

...

Keyword(s):

United States ◽

Percutaneous Coronary Intervention ◽

Older Patients ◽

Temporal Trends ◽

Coronary Intervention ◽

The United States ◽

Percutaneous Coronary

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ALL-052: New Therapeutics in Cancer Treatment: Analysis of Socioeconomic and Demographic Characteristics of Use Among Acute Lymphoblastic Leukemia (ALL) Patients in the United States

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/s2152-2650(21)01645-1 ◽

2021 ◽

Vol 21 ◽

pp. S264-S265

Author(s):

Saanie Sulley

Keyword(s):

United States ◽

Acute Lymphoblastic Leukemia ◽

Cancer Treatment ◽

Lymphoblastic Leukemia ◽

The United States ◽

Demographic Characteristics ◽

Treatment Analysis

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Poster: ALL-052: New Therapeutics in Cancer Treatment: Analysis of Socioeconomic and Demographic Characteristics of Use Among Acute Lymphoblastic Leukemia (ALL) Patients in the United States

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/s2152-2650(21)01287-8 ◽

2021 ◽

Vol 21 ◽

pp. S206

Author(s):

Saanie Sulley

Keyword(s):

United States ◽

Acute Lymphoblastic Leukemia ◽

Cancer Treatment ◽

Lymphoblastic Leukemia ◽

The United States ◽

Demographic Characteristics ◽

Treatment Analysis

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Managing Cancer Care During the COVID-19 Pandemic: Agility and Collaboration Toward a Common Goal

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2020.7560 ◽

2020 ◽

Vol 18 (4) ◽

pp. 366-369 ◽

Cited By ~ 123

Author(s):

Masumi Ueda ◽

Renato Martins ◽

Paul C. Hendrie ◽

Terry McDonnell ◽

Jennie R. Crews ◽

...

Keyword(s):

United States ◽

Cancer Treatment ◽

Cancer Care ◽

Rapid Change ◽

The United States ◽

Shared Vision ◽

Health Crisis ◽

Global Pandemic ◽

The Face ◽

Snohomish County

The first confirmed case of coronavirus disease 2019 (COVID-19) in the United States was reported on January 20, 2020, in Snohomish County, Washington. At the epicenter of COVID-19 in the United States, the Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, and University of Washington are at the forefront of delivering care to patients with cancer during this public health crisis. This Special Feature highlights the unique circumstances and challenges of cancer treatment amidst this global pandemic, and the importance of organizational structure, preparation, agility, and a shared vision for continuing to provide cancer treatment to patients in the face of uncertainty and rapid change.

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